Foot and Ankle Surgery for Chronic Nonhealing Wounds

Mayer, B.; Michetti, Laura A.

doi:10.1016/j.suc.2020.05.003

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Improvements in orthoplastic approaches may also prevent progression of amputation level by offering multidisciplinary wound management strategies, including pressure offloading with external fixators, tendon release, and exostectomy, and flaps for soft tissue coverage, such as the keystone perforator island flap, which has been successful in treating chronic wounds. 29,30 In this study, a small percentage of patients (6.63%) who originally received a BKA received a subsequent AKA. The rate of subsequent amputation was highest at 30 days and remained stable across all time periods.…”

Section: Versus 452%)mentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease

Beeson

Neubauer

Calvo

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Thirty-day mortality rates following major lower extremity amputations (LEAs) have declined from 22% in the late 1990s and early 2000s 1,2 to less than 7% by 2007. [3][4][5] Yet reported 5-year mortality rates in the literature have remained high, ranging from 40.4% 6 to 70%, 7 and major LEA, particularly above the knee amputation (AKA), continues to be cited as a significant predictor of mortality. 2,8 However, the majority of the literature supporting these rates is relatively old and may not reflect recent advances in medical disease management, perioperative and postoperative support, and advanced rehabilitative care. In older literature, the leading causes of death were pulmonary embolism and sepsis, suggesting that lack of mobility and postoperative complications were the major contributors to high mortality rates. 9 More recently, common ReconstructiveORiginal aRticle Background: Mortality rates following major lower extremity amputations (LEAs) 30 days-365 days postoperative have decreased, but 5-year rates remain high at 40.4%-70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to mortality more frequently than the amputation itself. Mortality rates between diabetic and nondiabetic patients were also analyzed. Methods: The California Office of Statewide Health Planning and Development hospital database was queried for patients admitted January 1, 2007-December 31, 2018. ICD-9-CM codes identified patients with vascular disease and an amputation procedure.Results: There were 26,669 patients. The 30-day, 90-day, 1-year, and 5-year major LEA mortality rates were 4.82%, 8.62%, 12.47%, and 18.11%, respectively. Weighted averages of 30-day, 90-day, 1-year, and 5-year major LEA mortality rates in the literature are 13%, 15.40%, 47.93%, and 60.60%, respectively. Mortality risk associated with vascular disease after amputation (hazard ratio = 22.07) was 11 times greater than risk associated with amputation-specific complications from impaired mobility (hazard ratio = 1.90; P < 0.01). Having diabetes was associated with lower mortality at 30 days, 90 days, and 1 year (P < 0.01) but not at 5 years (P = 0.22). Conclusions: This study suggests that people may be living longer after their major LEA than was previously thought. This study suggests that patients' PAD may play a bigger role in contributing to their mortality than complications from loss of mobility postamputation. Although having diabetes was associated with lower postamputation mortality, the difference was no longer significant by 5 years.

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Section: Versus 452%)mentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease

Beeson

Neubauer

Calvo

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…Optimal management of orthopedic wounds plays a critical role in facilitating the healing and recovery process for individuals with musculoskeletal injuries, postsurgical wounds, or chronic conditions impacting the bones and joints. [ 1 ] Ensuring effective wound care is essential to minimize the risk of infections and enhance overall healing outcomes. [ 2 ] While traditional hospital-based treatment is commonly associated with orthopedic wound management, the provision of personalized and convenient care within the confines of patients' own homes has emerged as a valuable alternative.…”

Section: Introductionmentioning

confidence: 99%

Effect of the home care model in orthopedic wounds management

Lei,

Xiang,

Chen

et al. 2023

Journal of Family Medicine and Primary Care

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Objective: To explore the effect of home care on orthopedic wound management. Materials and Methods: Patients with orthopedic wounds admitted from January 2020 to December 2022 were divided into a control group and a nursing group, with 23 cases in each group. After discharge, the control group was given routine health guidance and the nursing group was given home care. The mood score of the two groups of patients was evaluated, the time and cost were compared, and the patients' degree of trust and satisfaction with the medical staff were investigated. Results: The patients received home care had higher scores in mood, degree of trust and satisfaction with medical staff, and spent less time (P < .05). However, the cost was significantly higher than that of the control group (P < .05). Conclusions: Home care for patients with orthopedic wounds can significantly reduce the time spent on medical treatment. Moreover, improve patients' moods and trust and satisfaction with medical staff in a certain extent. However, better service often means more economic cost.

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“…Chronic wounds of the foot and ankle pose a significant challenge for a multidisciplinary team. The article "Foot and Ankle Surgery for Chronic Non healing Wounds" sought to highlight solutions to chronic wounds and demonstrate that these wounds must be managed from an orthoplastic perspective understanding both soft tissue healing principles, and the posed challenge of underlying osseous deformities 1 . Both nonsurgical and surgical interventions may be required for treatment of chronic wounds of the foot and ankle.…”

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confidence: 99%