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Diabetic Foot Infection: Preliminary Results of a Fast-Track Program with Early Endovascular Revascularization and Local Surgical Treatment
- Publication Year :
- 2016
-
Abstract
- Background To demonstrate that a fast-track program consisting in early endovascular revascularization and local surgical treatment saves tissue in patients with diabetic foot infection (DFI). Methods Between January and December 2014, 48 patients with DFI underwent early endovascular revascularization and local surgical treatment at our Diabetic Foot Center. In all cases, endovascular revascularization and local surgical treatment were performed within 1 week from the diagnosis of infection and during the same hospital stay. One-year outcomes were evaluated in terms of survival, primary patency, primary-assisted patency, secondary patency, absence of target lesion restenosis (TLR), and limb salvage. Results The patients were predominantly males (34 of 48, 70.8%) with a mean age of 72.4 years (range, 51–91). The target vessel was a tibial artery in 34 cases (70.8%). Surgical treatment consisted of debridement without bone resection in 27 cases (56.2%), toe and/or ray amputation in 15 cases (31.2%), Lisfranc amputation in 2 cases (4.2%), transmetatarsal amputation in 2 cases (4.2%). In the remaining 2 cases, a leg amputation was necessary with an overall 30-day major amputation rate of 4.2%. During the follow-up (mean duration 6.9 months, range 1–12) healing of the lesions was obtained in 30 cases (62.5%). Estimated 12-month survival, primary patency, primary-assisted patency, secondary patency, absence of TLR, and limb salvage rates were 83.5%, 53.4%, 65%, 65%, 60.7%, and 86.6%, respectively. Conclusions A fast-track program consisting in early endovascular revascularization and local surgical treatment contributes to our experience in limiting amputation levels in patients with DFI. A multidisciplinary approach and adoption of diabetic foot triage are essential to achieve these outcomes.
- Subjects :
- Target lesion
Male
medicine.medical_specialty
medicine.medical_treatment
030209 endocrinology & metabolism
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Aged
Aged, 80 and over
Amputation
Diabetic Foot
Female
Humans
Length of Stay
Middle Aged
Time-to-Treatment
Treatment Outcome
Vascular Patency
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Endovascular Procedures
Limb Salvage
Amputation, Surgical
03 medical and health sciences
0302 clinical medicine
Restenosis
Blood vessel prosthesis
80 and over
Medicine
Debridement
business.industry
General Medicine
medicine.disease
Diabetic foot
Surgery
Fast track
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0f39ed1fbc786ab7c8ef80c2ea275b0c