Preliminary experiences with early primary closure of foot wounds after lower extremity revascularization

Ann Vasc Surg. 2014 Jan;28(1):48-52. doi: 10.1016/j.avsg.2013.06.012. Epub 2013 Nov 1.

Abstract

Background: The costs associated with local wound care after revascularization can be significant, and it has been suggested that early closure or healing of foot wounds can be a source of cost savings. We sought to determine the safety and effectiveness of attempts to primarily close chronic foot wounds early after revascularization.

Methods: We performed a single-center 1-year review of patients who underwent primary wound closure during the same hospitalization as revascularization.

Results: Seven patients underwent an attempt at early primary wound closure. Most (71%) were diabetic. The wounds were primarily closed at a median of 6 days after revascularization (range 3-8 days). The limb-salvage rate at 6 months was 86%. Four patients remained completely healed with primary closure. One healed secondarily with wound care, and 2 required major amputation. Wound-closure techniques included the use of toe/forefoot amputations, skin grafting, and local flaps.

Conclusions: Early primary closure after revascularization may be a safe technique to consider for carefully selected foot wounds without ongoing soft tissue infection.

MeSH terms

  • Aged
  • Amputation, Surgical
  • Diabetic Foot / diagnosis
  • Diabetic Foot / surgery*
  • Endovascular Procedures* / adverse effects
  • Hospitalization
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay
  • Limb Salvage
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / diagnosis
  • Peripheral Vascular Diseases / surgery
  • Peripheral Vascular Diseases / therapy*
  • Reoperation
  • Skin Transplantation
  • Surgical Flaps
  • Texas
  • Time Factors
  • Time-to-Treatment*
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects
  • Wound Closure Techniques* / adverse effects
  • Wound Healing*