Annals of Vascular Diseases
Online ISSN : 1881-6428
Print ISSN : 1881-641X
ISSN-L : 1881-641X
Original Article
Efficacy of Early Closed Toe Amputation for Toe Ulcers with Suspected Osteomyelitis after Revascularization for Chronic Limb-Threatening Ischemia
Tsunehiro Shintani Sachi SuzukiNaoya KikuchiTakumi AriyaKayoko NatsumeKazuhiro OokuraJun OkuiYasunori SatoHideaki Obara
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JOURNAL OPEN ACCESS

2022 Volume 15 Issue 2 Pages 126-133

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Abstract

Objective: In this study, we aim to evaluate the efficacy of early closed toe amputation on the wound management of toe ulcers with suspected osteomyelitis after revascularization for chronic limb-threatening ischemia (CLTI).

Methods: This retrospective study included patients who have underwent revascularization for toe ulcers associated with CLTI at Shizuoka Red Cross Hospital from 2015 to 2021. Wound management comprised early closed toe amputation for toe ulcers with suspected osteomyelitis (19 toes in 17 patients) or conservative treatment (35 toes in 26 patients). The primary endpoint was wound healing after revascularization. We compared the wound healing rate at 90 days and median healing time of early closed toe amputation versus conservative treatment.

Results: Compared with the conservative treatment, early closed toe amputation was able to achieve a better wound healing rate at 90 days (89.5% vs. 68.6%; P<0.01) and a shorter median healing time (19 days vs. 62 days; P=0.01).

Conclusion: There remains no established wound management for toe lesions associated with CLTI. Despite its several disadvantages including wound infection and possible foot deformity, early closed toe amputation for toe ulcers with suspected osteomyelitis can be considered a safe approach in terms of wound management.

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© 2022 The Editorial Committee of Annals of Vascular Diseases. This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.

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