Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia

Abstract

Objectives: After surgical or endovascular revascularization, some ischemic lesions will not heal, while some others will heal at a variable period of time from the intervention, indicating a multifactorial interaction between local and systematic “wound healing–promoting” factors. Our objective was to identify predictors of wound healing following revascularization for chronic limb-threatening ischemia (CLTI). Methods: A literature review was performed to identify published research concerning clinical, biochemical, and noninvasive methods as predictors of wound healing time and wound-free period after surgical and endovascular revascularization for CLTI. Results: Our review indicated that potential predictors included local wound factors, wound depth, patient’s comorbidities, medications, smoking and alcohol abuse, poor vessel runoff, and direct versus indirect revascularization. Among the clinical biomarkers, platelet-derived growth factor, transforming growth factor β, basic fibroblast growth factor, tumor necrosis factor α, interleukin (IL) 1, and IL-6 have been proposed as potential predictors. Furthermore, the potential of noninvasive microcirculation assessment to predict proper wound healing has been the topic of extensive investigation. Among the novel methods, transcutaneous measurement of oxygen partial pressure, skin perfusion pressure, oxygen-to-see method, indocyanine green fluorescence imaging, and multispectral optoacoustic tomography have shown promising results. Conclusions: The risk factor profile of an ischemic lesion in the lower extremities with a delayed/failed healing response, following a successful revascularization, is not fully clarified. Although many predictors have been assessed so far, further research needs to be done to identify the optimal clinical and biochemical indices and the noninvasive technique assessing the microcirculation that is associated with complete wound healing.

Efficacy of A Novel Smart Polymeric Nanodrug in the Treatment of Experimental Wounds in Rats

“…This is due to the increasing number of surgeries in the world, as well as domestic and workplace injuries and combat wounds [10][11][12][13][14]. Furthermore, the increase in life expectancy is accompanied by an increase in the prevalence of chronic trophic ulcers of various origin, the healing of which is a clinical problem [15][16][17][18]. The problem of wound healing is especially important in cases when the patients cannot be continuously monitored by clinicians and in cases when there are special requirements for the surgical scar, e.g., in aesthetic surgery [19].…”

Mobile Health–Based Thermometer for Monitoring Wound Healing After Endovascular Therapy in Patients With Chronic Foot Ulcer: Prospective Cohort Study

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Dinamics of skin wound healing with the use of injectable regeneration stimulators in rats

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“…Актуальность проблемы заживления ран постоянно нарастает, что связано с ростом распространенности хронических трофических язв [1][2][3], а также увеличением числа хирургических вмешательств и травм [4][5][6]. Независимо от этиологии ран и сопутствующей патологии в процессе их заживления можно выделить ключевые процессы.…”