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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
1995-5-5
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pubmed:abstractText |
Wound complications of the pedal incision continue to compromise successful limb salvage following aggressive revascularization. Significant distal wound disruption occurred in 14 of 142 (9.8%) patients undergoing pedal bypass with autogenous vein for limb salvage between 1986 and 1993. One hundred forty-two pedal bypass procedures were performed for rest pain in 66 patients and tissue necrosis in 76. Among the 86 men and 56 women, 76% were diabetic and 73% were black. All but eight patients had a history of diabetes and/or tobacco use. Eight wounds were successfully managed with maintenance of patent grafts from 5 to 57 months. Exposure of a patent graft precipitated amputation in three patients, as did graft occlusion in an additional patient. One graft was salvaged by revision to the peroneal artery and one was covered by a local bipedicled flap. Multiple regression analysis identified three factors associated with wound complications at the pedal incision site: diabetes mellitus (p = 0.03), age > 70 years (p = 0.03), and rest pain (p = 0.05). Ancillary techniques ("pie-crusting") to reduce skin tension resulted in no distal wound problems among 15 patients considered to be at greatest risk for wound breakdown. Attention to technique of distal graft tunneling, a wound closure that reduces tension, and control of swelling by avoiding dependency on and use of gentle elastic compression assume crucial importance in minimizing pedal wound complications following pedal bypass.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Jan
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pubmed:issn |
0890-5096
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
9
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
53-9
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pubmed:dateRevised |
2004-11-17
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pubmed:meshHeading |
pubmed-meshheading:7703063-Adult,
pubmed-meshheading:7703063-Age Factors,
pubmed-meshheading:7703063-Aged,
pubmed-meshheading:7703063-Aged, 80 and over,
pubmed-meshheading:7703063-Diabetes Complications,
pubmed-meshheading:7703063-Female,
pubmed-meshheading:7703063-Foot,
pubmed-meshheading:7703063-Humans,
pubmed-meshheading:7703063-Ischemia,
pubmed-meshheading:7703063-Male,
pubmed-meshheading:7703063-Middle Aged,
pubmed-meshheading:7703063-Pain,
pubmed-meshheading:7703063-Postoperative Complications,
pubmed-meshheading:7703063-Risk Factors,
pubmed-meshheading:7703063-Smoking,
pubmed-meshheading:7703063-Vascular Patency
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pubmed:year |
1995
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pubmed:articleTitle |
Distal wound complications following pedal bypass: analysis of risk factors.
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pubmed:affiliation |
Section of Vascular Surgery, Medical University of South Carolina, Charleston 29425, USA.
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pubmed:publicationType |
Journal Article
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