Aggressive Wound Care by a Multidisciplinary Team Improves Wound Healing after Infrainguinal Bypass in Patients with Critical Limb Ischemia

Mii, Shinsuke; Tanaka, Kiyoshi; Kyuragi, Ryoichi; Ishimura, Hiroshi; Yasukawa, Shinsuke; Guntani, Atsushi; Kawakubo, Eisuke

doi:10.1016/j.avsg.2016.09.024

Cited by 31 publications

(19 citation statements)

References 22 publications

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“…Our data suggest that the positive or negative predictive value of these markers is quite high. This experience confirms the central role of wound healing as the indicator of outcomes after limbs revascularisation; an adequate and aggressive wound management strategy is needed and recommended in patient with CLI, and the use of NPWT can help to debride, hydrate, or granulate and to speed up the healing process . Furthermore, our findings also raise the important question whether a more aggressive anti‐inflammatory therapy associated with peripheral arterial reconstruction may improve the postoperative outcomes of these patients .…”

Section: Discussionsupporting

confidence: 76%

Local release of metalloproteinases and their inhibitors after a successful revascularisation procedure

Grande

Brachini

Sterpetti

et al. 2019

International Wound Journal

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Section: Discussionsupporting

confidence: 76%

Local release of metalloproteinases and their inhibitors after a successful revascularisation procedure

Grande

Brachini

Sterpetti

et al. 2019

International Wound Journal

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“…Data from one additional study 1 ) supported the 2016 AHA/ACC guideline based on previous literature appraised 2 – 5 ) . In the appraised study of Mii et al 1 ) , a multidisciplinary team of specialists was in charge of wound care and this included specialists in vascular surgery, radiology, cardiology, cerebrovascular neurology, diabetes, renal disease, infection, rehabilitation, prosthetics and orthotics who held weekly conferences regarding patients with CLI.…”

Section: Appraisal Of Aha/acc Guideline Statements and The Appadc Recmentioning

confidence: 64%

“…Mii et al 1 ) reviewed 126 consecutive patients undergoing infrainguinal bypass for tissue loss. Prior to March 2013, standard wound care (SWC) and negative pressure wound therapy (when necessary) was done by vascular surgeons.…”

Section: Appraisal Of Aha/acc Guideline Statements and The Appadc Recmentioning

confidence: 99%

Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee

Abola

Golledge

Miyata

et al. 2020

JAT

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Background: Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic modalities, and even patient treatment response. The Asian Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) thus coordinated the development of an Asia-Pacific Consensus Statement (APCS) on the Management of PAD. Objectives: The APSAVD aimed to accomplish the following: 1) determine the applicability of the 2016 AHA/ ACC guidelines on the Management of Patients with Lower Extremity Peripheral Artery Disease to the Asia-Pacific region; 2) review Asia-Pacific literature; and 3) increase the awareness of PAD. Methodology: A Steering Committee was organized to oversee development of the APCS, appoint a Technical Working Group (TWG) and Consensus Panel (CP). The TWG appraised the relevance of the 2016 AHA/ACC PAD Guideline and proposed recommendations which were reviewed by the CP using a modified Delphi technique. Results: A total of 91 recommendations were generated covering history and physical examination, diagnosis, and treatment of PAD-3 new recommendations, 31 adaptations and 57 adopted statements. This Asia-Pacific Consensus Statement on the Management of PAD constitutes the first for the Asia-Pacific Region. It is intended for use by health practitioners involved in preventing, diagnosing and treating patients with PAD and ultimately the patients and their families themselves.

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“…[14][15][16] According to the literature, 17 especially in diabetes, 18 another very important aspect is the postoperative wound management that must necessarily be adequate and "aggressive" to ensure healing. 19 The points above described have been partially disregarded because to the epochal event of which the whole world was a victim: the COVID-19 pandemic. During its critical phase, many hospitals in Italy have intentionally reduced non-emergent elective procedures and hospitalisations to preserve hospital capacity and to ensure treatment of several respiratory symptoms.…”

Section: Discussionmentioning

confidence: 99%

A multistage combined approach to promote diabetic wound healing in COVID‐19 era

Grande

Fiori

Russo

et al. 2020

International Wound Journal

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When diabetes mellitus is not properly controlled with drugs and a healthy lifestyle, it exposes patients with advanced peripheral arterial disease or critical limb ischaemia (CLI) to the most serious complications, in particular lower limb ulcers. Surgical or endovascular treatments represent the first line of intervention; in addition, the adequate management of ulcers can guarantee not only a faster wound healing but also the improvement of the patient's prognosis. To speed up this process, negative pressure wound therapy (NPWT), platelet‐rich plasma (PRP), and other advanced moist wound dressing have been proposed. During Coronavirus disease 2019 (COVID‐19) pandemic, many patients with CLI and diabetes mellitus had difficult access to advanced treatments with a significant reduction in life expectancy. We report the cases of patients with non‐healing ulcers and CLI treated with an empiric multistage approach after successful endovascular revascularisation; the postoperative course was eventful in all patients, and foot ulcers are currently in an advanced state of healing. The association between adequate revascularisation, systemic anti‐inflammatory, and antibiotic therapy with the multistage advanced medications ensures healing of ulcers, limb salvage, and improvement of patient prognosis.

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Aggressive Wound Care by a Multidisciplinary Team Improves Wound Healing after Infrainguinal Bypass in Patients with Critical Limb Ischemia

Cited by 31 publications

References 22 publications

Local release of metalloproteinases and their inhibitors after a successful revascularisation procedure

Local release of metalloproteinases and their inhibitors after a successful revascularisation procedure

Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee

A multistage combined approach to promote diabetic wound healing in COVID‐19 era

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