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1.
Bone Joint J ; 103-B(2): 415-420, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517731

RESUMO

AIMS: The aims of this study is to report the clinical and radiological outcomes after pre-, central-, and postaxial polydactyly resection in children from a tertiary referral centre. METHODS: All children who underwent resection of a supernumerary toe between 2001 and 2013 were prospectively enrolled and invited for a single re-assessment. Clinical parameters and several dedicated outcome scores (visual analogue scale (VAS), Paediatric Outcomes Data Collection Instrument (PODCI), Activities Scale for Kids (ASK), and American Orthopaedic Foot and Ankle Society Score (AOFAS)) were obtained, as were radiographs of the operated and non-operated feet along with pedobarographs. RESULTS: In all, 39 children (52 feet) with a mean follow-up of 7.2 years (3.1 to 13.0) were included in the study. Resection of a duplicated great toe was performed in ten children, central polydactyly in four, and postaxial polydactyly in 26. The mean postoperative VAS (0.7; 0 to 7), ASK (93.7; 64.2 to 100), and AOFAS range (85.9 to 89.0) indicated excellent outcomes among this cohort and the PODCI global functioning scale (95.7; 75.5 to 100) was satisfactory. No significant differences were found regarding outcomes of pre- versus postaxial patients, nor radiological toe alignment between the operated and non-operated sides. Minor complications were observed in six children (15%). There were seven surgical revisions (18%), six of whom were in preaxial patients. In both groups, below the operation area, a reduced mean and maximum force was observed. Changes in the hindfoot region were detected based on the prolonged contact time and reduced force in the preaxial group. CONCLUSION: Excellent mid-term results can be expected after foot polydactyly resection in childhood. However, parents and those who care for these children need to be counselled regarding the higher risk of subsequent revision surgery in the preaxial patients. Also, within the study period, the plantar pressure distribution below the operated part of the foot did not return to completely normal. Cite this article: Bone Joint J 2021;103-B(2):415-420.


Assuntos
Pé/fisiopatologia , Procedimentos Ortopédicos , Polidactilia/fisiopatologia , Polidactilia/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Pé/cirurgia , Humanos , Lactente , Masculino , Polidactilia/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento
2.
Medicine (Baltimore) ; 100(1): e22393, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429725

RESUMO

ABSTRACT: Calcaneal fractures are rare in pediatric population, with more displaced intra-articular fractures encountered due to the increasing number of high-energy trauma. Operative interventions are gaining popularity because of the unsatisfactory outcomes of traditional conservative methods. This study investigated the clinical outcomes of a minimally invasive technique using the sinus tarsi approach and external fixator in the treatment of intra-articular calcaneal fractures in pediatric patients.Patients who underwent open reduction between January 2010 and January 2018 at our institute were included in this study and reviewed retrospectively. Radiological and clinical parameters were all recorded and analyzed.Overall, 29 patients were included in the study, including 23 boys and 6 girls (10.2 ±â€Š2.2 years old). The average follow-up was 29.5 months postoperatively (range, 26-72 months). Bohler angle was 15.2 ±â€Š3.3° preoperatively, and 34.0 ±â€Š3.8° postoperatively (P < .001); Gissane angle was 101.8 ±â€Š6.2 degrees preoperatively, and 129.7 ±â€Š6.2° postoperatively (P < .001). The average length of incision was 3.4 ±â€Š0.7 cm. At the last follow-up, all patients showed satisfactory clinical outcomes and the score was 90.0 ±â€Š2.3 according to American Orthopedic Foot and Ankle Society Scale.Minimally invasive approach with external fixator is an effective method for treating displaced intra-articular calcaneal fractures in pediatric patients, with a lower incidence of wound-related complications and good cosmetic outcomes.


Assuntos
Calcâneo/lesões , Calcâneo/cirurgia , Fixadores Externos/normas , Adolescente , Criança , Pré-Escolar , Fixadores Externos/efeitos adversos , Fixadores Externos/tendências , Feminino , Pé/cirurgia , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/cirurgia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Resultado do Tratamento
3.
Orthopade ; 50(4): 306-311, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33416924

RESUMO

BACKGROUND: The reconstruction of defects in the foot region is a challenge due to the anatomical peculiarities of the soft tissue covering. OBJECTIVE: This article presents the results of the reconstruction of postoperative foot defects using the free femoral periosteal flap (FFPF). MATERIAL AND METHODS: In a patient collective (n = 10) with postoperative wound healing disorders of the foot, the defect zone was covered using a vascularized FFPF from the distal femoral region. The wound healing process was retrospectively analyzed. RESULTS: The mean follow-up time was 20.2 ± 8.22 months (7-35 months). All patients had a soft tissue defect in the foot region with a mean area of 17.9 ± 3.72 cm2 (12-24 cm2). On average, a wound healing disorder occurred 2 weeks after the primary surgery. In the group of patients followed up the vascularized FFPF enabled a stable, definitive and aesthetically pleasing reconstruction and contributed to the bony consolidation. The duration of inpatient care after defect closure was 8-10 days and was significantly less than the duration of wound management prior to transplantation of the FFPF. CONCLUSION: The FFPF is an effective and elegant method for the regenerative reconstruction of defects with accompanying osseous components in the foot region. The FFPF has the advantage of instant thin and pliable tissue coverage in contrast to many other reconstructive methods. The FFPF can promote wound consolidation through the regenerative properties of a vascularized periosteal sheath in the context of a one-step and permanent infection control.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles , Pé/cirurgia , Humanos , Estudos Retrospectivos , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos
4.
Clin Podiatr Med Surg ; 38(1): 17-29, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33220742

RESUMO

In the diabetic and peripheral vascular disease population there is a high risk of further amputation following a primary amputation. Amputation surgery is often approached negating the biomechanics of the lower extremity leading to complications or additional surgery. Implementing appropriate tendon balancing of stump and applying orthoplastic techniques will improve outcomes. This article introduces the basic techniques to a wider audience of foot and ankle surgeons. Specifically, this article is intended to be a descriptive guide for the use of tendon balancing and intrinsic muscle advancements in the various levels of foot amputations.


Assuntos
Amputação/métodos , Pé/cirurgia , Hallux/cirurgia , Humanos , Ossos do Metatarso/cirurgia , Músculo Esquelético/cirurgia , Retalhos Cirúrgicos , Transferência Tendinosa
6.
Medicine (Baltimore) ; 99(40): e22506, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019450

RESUMO

RATIONALE: Primary repair of acute ligament injury is possible due to the proximity of the ends. In the case of chronic injury, however, primary repair is difficult because the ends of ruptured ligament will have receded, and tendon graft, transfer, or reconstruction is needed. Satisfactory clinical results have been reported after reconstruction with newly formed interposed scar tissue between the ends of the ruptured tendon in chronic Achilles tendon injury and chronic extensor halluces longus (EHL) tendon injury. Here, we report a patient treated with reconstructive surgery using well-formed scar tissue between the ends in a case of chronic EDL tendon rupture. PATIENT CONCERNS: A 34-year-old woman visited the clinic with pain in the dorsum aspect of the right foot associated with weakness and loss of extension of the second toe. She had sustained an injury to the dorsal aspect of her foot by falling on broken glass 3 months before coming to our clinic. The patient reported pain and limitation of the extension of the second toe for 2 months. Her pain continued to worsen, and 1 month later she was transferred to our hospital because a different local clinician suspected she had ruptured her second EDL tendon. DIAGNOSIS: Magnetic resonance imaging (MRI) revealed complete rupture of the second EDL tendon at the metatarsal neck junction, with displacement of the distal end to the proximal phalanx shaft area and of the proximal end to the metatarsal shaft area. INTERVENTIONS: Chronic rupture of the EDL tendon was treated with direct reconstruction using interposed scar tissue. OUTCOMES: At the 3-month follow-up, the patient was almost asymptomatic and had nearly full range of motion in dorsiflexion of the second toe. She has no discomfort in her daily life and has returned to almost her preoperative level of functional activities. LESSONS: Here, we presented an extremely rare case of reconstruction using interposed scar tissue in a patient with neglected EDL tendon rupture. Direct reconstruction using interposed scar tissues located between the ends of the ruptured tendon is considered a reliable method with satisfactory clinical results in carefully selected patients.


Assuntos
Cicatriz/cirurgia , Pé/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traumatismos dos Tendões/cirurgia , Adulto , Doença Crônica , Feminino , Humanos
9.
Surg Clin North Am ; 100(4): 707-725, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32681871

RESUMO

Chronic wounds often are the result of bone deformities, compounded by musculotendinous and ligamentous imbalance. Sensory neuropathy places patients at greater risk for acute wounds to develop into chronic wounds. Etiologies of these deforming forces include Charcot neuroarthropathy, trauma, and congenital and acquired neuromuscular disorders. Management of these deformities ranges from simple relief of pressure with soft inserts to bracing for mechanical instability. Correction of more complex deformities requires resection of bone, osteotomies, fusions, and external fixation. Tendon and ligament imbalance must be addressed at all levels of deformity. Postoperatively, patients must be re-evaluated for continuation of orthoses and bracing.


Assuntos
Articulação do Tornozelo/cirurgia , Pé/cirurgia , Cicatrização/fisiologia , Ferimentos e Lesões/cirurgia , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/cirurgia , Braquetes , Doença Crônica , Desbridamento , Desenho de Equipamento , Traumatismos do Pé/fisiopatologia , Traumatismos do Pé/cirurgia , Humanos , Aparelhos Ortopédicos , Osteomielite/fisiopatologia , Osteomielite/cirurgia , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos , Tendinopatia/fisiopatologia , Tendinopatia/cirurgia , Ferimentos e Lesões/fisiopatologia
10.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(7): 848-853, 2020 Jul 15.
Artigo em Chinês | MEDLINE | ID: mdl-32666727

RESUMO

Objective: To investigate the effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament (ACL) insertion in rabbits. Methods: Eighty healthy New Zealand white rabbits were harvested to prepare ACL injury models and randomly divided into two groups ( n=40). The ACL was reconstructed with vascularized peroneus longus tendon graft in group A and peroneus longus tendon graft without blood supply in group B. The survival of animals and the healing of incision were observed after operation; the grafts were taken for gross and histological observations at 4, 8, and 16 weeks; the biomechanical test of the grafts was carried out to record the maximum tensile strength and incidence of ACL insertion rupture at 8 and 16 weeks. Results: All animals survived until the experiment completed. General observation showed that the tunnel was combined with grafts, the vascular infiltration was abundant, and no obvious boundary between the tunnel and grafts existed at 16 weeks in group A; there was still an obvious boundary between the tunnel and graft in group B. Histological observation showed that the collagen fibers between tendon and bone in group A increased gradually, the dense fiber connection was formed, and the "tidal-line" like structure similar to the normal ACL insertion was formed at 16 weeks; but the"tidal-line" like structure was not obvious in group B. Biomechanical test showed that there was no significant difference in the incidence of ACL insertion rupture at 8 and 16 weeks between group A and group B ( P=0.680; P=0.590), but the maximum tensile strength at 8 and 16 weeks were higher in group A than in group B ( t=18.503, P=0.001; t=25.391, P=0.001). Conclusion: The vascularized peroneus longus tendon graft for ACL reconstruction can obviously promote the outcome of the ACL insertion.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Animais , Ligamento Cruzado Anterior/cirurgia , Pé/cirurgia , Coelhos , Tendões/cirurgia
11.
J Am Acad Orthop Surg ; 28(14): e595-e603, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32692095

RESUMO

Weight-bearing CT (WBCT) scans of the foot and ankle have improved the understanding of deformities that are not easily identified on radiographs and are increasingly being used by orthopaedic surgeons for diagnostic and preoperative planning purposes. In contrast to standard CT scans, WBCT scans better demonstrate the true orientation of the bones and joints during loading. They have been especially useful in investigating the alignment of complex pathologies such as adult-acquired flatfoot deformity in which patients have been found to have a more valgus subtalar joint alignment than in a normal cohort and high rates of subfibular impingement. Studies using WBCT scans have also provided new insight into more common lower extremity conditions such as hallux valgus, ankle fractures, and lateral ankle instability. WBCT scans have allowed researchers to investigate pronation of the first metatarsal in patients with hallux valgus compared with normal feet, and patients with lateral ankle instability have been found to have more heel varus than healthy control subjects. Understanding the application of WBCT scans to clinical practice is becoming more important as surgeons strive for improved outcomes in the treatment of complicated foot and ankle disorders.


Assuntos
Tornozelo/diagnóstico por imagem , Tornozelo/fisiopatologia , Pé Chato/diagnóstico por imagem , Pé Chato/fisiopatologia , Pé/diagnóstico por imagem , Pé/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Suporte de Carga , Tornozelo/cirurgia , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/fisiopatologia , Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/cirurgia , Pé Chato/cirurgia , Pé/cirurgia , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/fisiopatologia , Hallux Valgus/cirurgia , Humanos , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/fisiopatologia , Instabilidade Articular/cirurgia , Planejamento de Assistência ao Paciente
12.
Acta Orthop Traumatol Turc ; 54(3): 262-268, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32544062

RESUMO

OBJECTIVE: The aim of this study was to analyze the results of the split anterior tibialis tendon transfer (SPLATT) to peroneus tertius (PT) for equinovarus foot deformity in children with cerebral palsy (CP). METHODS: The medical records of 25 ambulatory CP patients (mean age: 8.7±3.2 years, range: 4-16 years) with equinovarus foot (33 feet), who underwent SPLATT to PT surgery between 2014 and 2016, were retrospectively reviewed. A senior surgeon performed all the surgical procedures. SPLATT was performed as part of a single-event multilevel surgery for the lower limb, and the concomitant procedures on the same extremity were recorded. The patients who required any additional foot or ankle surgery that could affect the clinical outcome (except heel cord lengthening) were excluded from the study. The Kling's College Criteria were used to evaluate the procedural outcome of the foot position and gait, and the associated complications were recorded. RESULTS: The mean follow-up time was 28.8±5 months (range: 24-42 months). The postoperative Kling scores were excellent for 27 feet of the patients who had a plantigrade foot, without fixed or postural deformity, in a regular shoe, having no calluses; good for 5 cases for those who walked with less than 5° varus, valgus, or equinus posture of the hind foot, wearing regular shoes, having no callosities; and fair for 1 case for those who had recurrence of the deformity. There was only one wound detachment, which was treated with wound care and dressing. None of the patients had overcorrection, infection, or bone fracture. CONCLUSION: The dynamic SPLATT to PT surgery for the management of the equinovarus foot deformities in the CP patients is a safe and less complicated surgical alternative with a good functional outcome. It is a safe and effective treatment method for the management of equinovarus foot deformities in CP. LEVEL OF EVIDENCE: Level IV, Therapeutic study.


Assuntos
Paralisia Cerebral/complicações , Pé Torto Equinovaro , Espasticidade Muscular , Transferência Tendinosa , Tendões , Paralisia Cerebral/fisiopatologia , Pré-Escolar , Pé Torto Equinovaro/etiologia , Pé Torto Equinovaro/fisiopatologia , Pé Torto Equinovaro/cirurgia , Feminino , Pé/fisiopatologia , Pé/cirurgia , Humanos , Masculino , Espasticidade Muscular/complicações , Espasticidade Muscular/cirurgia , Avaliação de Processos e Resultados em Cuidados de Saúde , Recuperação de Função Fisiológica , Estudos Retrospectivos , Transferência Tendinosa/efeitos adversos , Transferência Tendinosa/métodos , Tendões/fisiopatologia , Tendões/cirurgia
13.
Orthop Clin North Am ; 51(3): 403-422, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32498959

RESUMO

This article presents the indications, contraindications, preoperative surgical planning, surgical technique, and postoperative management of some of the most common percutaneous procedures in orthopedic foot and ankle surgery. The background of each procedure also is presented, supported by the latest in published literature to educate surgeons. Such topics include percutaneous bunionectomy, lesser toe deformity and bunionette correction, calcaneal osteotomy, cheilectomy, and first metatarsophalangeal joint arthrodesis.


Assuntos
Ossos do Pé/cirurgia , Procedimentos Ortopédicos/métodos , Tornozelo/diagnóstico por imagem , Tornozelo/cirurgia , Artrodese/efeitos adversos , Artrodese/métodos , Pé/diagnóstico por imagem , Pé/cirurgia , Ossos do Pé/diagnóstico por imagem , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Ortopédicos/efeitos adversos , Osteotomia/efeitos adversos , Osteotomia/métodos , Falanges dos Dedos do Pé/diagnóstico por imagem , Falanges dos Dedos do Pé/cirurgia
14.
Artigo em Inglês | MEDLINE | ID: mdl-32485917

RESUMO

Of the five nerves that innervate the foot, the one in which anesthetic blocking presents the greatest difficulty is the tibial nerve. The aim of this clinical trial was to establish a protocol for two tibial nerve block anesthetic techniques to later compare the anesthetic efficiency of retromalleolar blocking and supramalleolar blocking in order to ascertain whether the supramalleolar approach achieved a higher effective blocking rate. A total of 110 tibial nerve blocks were performed. Location of the injection site was based on a prior ultrasound assessment of the tibial nerve. The block administered was 3 mL of 2% mepivacaine. The two anesthetic techniques under study provided very similar clinical results. The tibial nerve success rate was 81.8% for the retromalleolar technique and 78.2% for the supramalleolar technique. No significant differences in absolute latency time (p = 0.287), percentage of effective nerve blocks (p = 0.634), anesthetic block duration (p = 0.895), or pain level during puncture (p = 0.847) were found between the two techniques. The greater ease in locating the tibial nerve at the retromalleolar approach could suggest that this is the technique of choice for tibial nerve blocking, especially in the case of professionals new to the field. The supramalleolar technique could be worth considering for those more experienced professionals.


Assuntos
, Bloqueio Nervoso , Nervo Tibial , Feminino , Pé/cirurgia , Humanos , Injeções , Masculino , Ultrassonografia
16.
Arch Phys Med Rehabil ; 101(10): 1711-1719, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32473951

RESUMO

OBJECTIVES: To determine which demographic, amputation, and health-related factors were associated with health-related quality of life (HR-QoL) in people living with partial foot amputation (PFA) or transtibial amputation (TTA). DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS: Adults (N=123) with unilateral PFA (n=42) or TTA (n=81). INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: Medical Outcome Short Form (SF-36) version 2. RESULTS: Variation in the SF-36 Physical or Mental Component Summary scores were associated with complex interactions between factors, including: time since amputation, fatigue, anxiety, depression, pain interference, and physical function. Level of amputation (ie, PFA or TTA) did not explain a significant part of the variation in either the SF-36 Physical or Mental Component Summary scores. CONCLUSIONS: Given the complex interactions between factors associated with the physical and mental health components of HR-QoL, there are opportunities to consider the long-term holistic care required by people living in the community with PFA or TTA.


Assuntos
Amputação/psicologia , Nível de Saúde , Saúde Mental , Qualidade de Vida/psicologia , Adulto , Fatores Etários , Idoso , Comorbidade , Estudos Transversais , Complicações do Diabetes/epidemiologia , Feminino , Pé/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Desempenho Físico Funcional , Fatores Socioeconômicos , Tíbia/cirurgia , Fatores de Tempo
17.
Vasc Med ; 25(2): 118-123, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366205

RESUMO

Disturbed wound healing (DWH) following elective foot and ankle surgery is associated with a number of known risk factors. The purpose of this study was to determine if peripheral artery disease (PAD) is a potential risk factor that contributes to an increase in postoperative DWH. In a case-control study, we analyzed all patients undergoing elective foot and ankle surgery between January 1, 2014 and December 31, 2017 at two institutions and identified 51 patients with postoperative DWH. After matching with 51 control patients without DWH, all 102 patients were evaluated for PAD. The prevalence of PAD was significantly higher in the DWH group compared to the control group (41.2% vs 19.6%, p < 0.01). This difference was even more distinctive for patients with any abnormal ankle-brachial index (ABI) (51.0% vs 19.6%, p < 0.001). After adjustment for diabetes, hypertension, hypercholesterolemia, and smoking, any abnormal ABI or a history of PAD remained an independent risk factor for DWH (odds ratio 3.28; 95% CI 1.24-8.71). In this dual-center study, postoperative DWH was associated with significantly higher rates of PAD. These findings suggest that preoperative evaluation for PAD could be a helpful tool to identify patients at high risk for postoperative wound complications undergoing foot and ankle surgery. This trial is registered with drks.de, number DRKS00012580.


Assuntos
Índice Tornozelo-Braço , Tornozelo/cirurgia , Pé/cirurgia , Doenças Musculoesqueléticas/cirurgia , Procedimentos Ortopédicos/efeitos adversos , Doença Arterial Periférica/epidemiologia , Cicatrização , Idoso , Procedimentos Cirúrgicos Eletivos , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/epidemiologia , Doença Arterial Periférica/diagnóstico , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
19.
J Med Life ; 13(1): 45-49, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32341700

RESUMO

The problem of lower limb preservation with symptoms of critical ischemia, resulting in necrosis of the distal foot portion, remains open. These cases require solving few tactical questions, such as the primary revascularization method, limb-preserving amputation, stimulation of regeneration, and finally, determining the criteria for auto-dermal transplantation. We analyzed 29 patient cases with critical lower limb ischemia of fourth grade, according to the Fontaine classification (or the sixth category according to Rutherford's classification), who underwent partial foot amputation due to dry gangrene and were threated using PRGF®-ENDORET® platelet-rich plasma and platelet-rich fibrin technology. The control group was comprised of 21 patients who received traditional postoperative wound treatment. All patients went through a combination of transluminal revascularization and platelet-rich plasma to create a "therapeutic" neoangiogenic effect. Indications for these procedures were severe distal arterial occlusion and stenosis. Using transluminal procedures with platelet-rich plasma therapy improves the blood perfusion to the distal portions of the limb in patients with critical ischemia in a short time, which is an informative diagnostic criterion for wound healing after amputation. Plasmatic membranes create an optimal environment for tissue regeneration, thus reducing the wound closure time using an auto-dermal transplant.


Assuntos
Amputação , Pé/cirurgia , Isquemia/terapia , Fibrina Rica em Plaquetas/metabolismo , Plasma Rico em Plaquetas/metabolismo , Citocinas/sangue , Humanos , Isquemia/sangue , Masculino , Pessoa de Meia-Idade , Temperatura Cutânea , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/administração & dosagem , Cicatrização
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