E Eskelinen 1 , I Kaartinen 2 , M Kääriäinen 2 , H Kuokkanen 2 Show Affiliations »
Abstract
BACKGROUND AND AIMS: Complex nontraumatic foot lesions often lead to major lower-limb amputation in diabetic patients. We aimed to evaluate outcome of free flap transfer in such cases. MATERIALS AND METHODS: A total of 11 consecutive diabetic patients, hospitalized between 2007 and 2012 at a university central hospital for a free flap transfer, were followed until September 2013. Amputation-free survival, patient survival, and complete wound healing were defined as primary endpoints. Healing time of tissue lesions was analyzed. All pre- and postoperative data were retrospectively collected from hospital charts. RESULTS: Complete tissue healing at 6 and 12 months after free flap transfer were 55% (6/11) and 82% (9/11), respectively. The median time to complete tissue healing was 123 days (range, 45-207 days). Overall limb salvage, survival, and amputation-free survival rates at 12 months were 90%, 91%, and 82%, respectively. The clinically important endpoint, namely, amputation-free survival with completely healed wounds, was attained in 9 of 11 patients at 1 year. CONCLUSION: Free tissue transfer enables successful wound healing and limb salvage rather than amputation in selected diabetic patients with difficult-to-heal wounds. Complete healing of tissue lesions is slow even after successful surgery. Preoperative assessment of the condition of patients is the key to success. © The Finnish Surgical Society 2014.
BACKGROUND AND AIMS: Complex nontraumatic foot lesions often lead to major lower-limb amputation in diabetic patients . We aimed to evaluate outcome of free flap transfer in such cases. MATERIALS AND METHODS: A total of 11 consecutive diabetic patients , hospitalized between 2007 and 2012 at a university central hospital for a free flap transfer, were followed until September 2013. Amputation-free survival, patient survival, and complete wound healing were defined as primary endpoints. Healing time of tissue lesions was analyzed. All pre- and postoperative data were retrospectively collected from hospital charts. RESULTS: Complete tissue healing at 6 and 12 months after free flap transfer were 55% (6/11) and 82% (9/11), respectively. The median time to complete tissue healing was 123 days (range, 45-207 days). Overall limb salvage, survival, and amputation-free survival rates at 12 months were 90%, 91%, and 82%, respectively. The clinically important endpoint, namely, amputation-free survival with completely healed wounds, was attained in 9 of 11 patients at 1 year. CONCLUSION: Free tissue transfer enables successful wound healing and limb salvage rather than amputation in selected diabetic patients with difficult-to-heal wounds. Complete healing of tissue lesions is slow even after successful surgery. Preoperative assessment of the condition of patients is the key to success. © The Finnish Surgical Society 2014.
Entities: Disease
Species
Keywords:
Free tissue transfer; amputation-free survival with healing; diabetic foot; limb salvage; tissue healing; ulcer healing
Mesh： See more »
Year: 2014
PMID： 24694779 DOI： 10.1177/1457496914524389
Source DB: PubMed Journal: Scand J Surg ISSN： 1457-4969 Impact factor: 2.360