Impact of Antimicrobial-Resistant Bacterial and Polymicrobial Infection on Wound Healing After Minor Forefoot Amputation in Chronic Limb-Threatening Ischemia With Infection

被引:3
|
作者
Kato, Taku [1 ,5 ]
Yanagiuchi, Takashi [1 ]
Hirano, Keita [2 ]
Imura, Haruki [3 ]
Matsubara, Kunihiko [4 ]
Hanabusa, Katsuyuki [1 ]
Ota, Yutaro [1 ]
Yamazaki, Shinya [1 ]
Ushimaru, Shunpei [1 ]
Yokoi, Hirokazu [1 ]
机构
[1] Rakuwakai Otowa Hosp, Dept Cardiol, Kyoto, Japan
[2] Kyoto Univ, Grad Sch Med, Kyoto, Japan
[3] Rakuwakai Otowa Hosp, Dept Infect Dis, Kyoto, Japan
[4] Rakuwakai Otowa Hosp, Limb Wound Ctr Rakuwakai, Kyoto, Japan
[5] Rakuwakai Otowa Hosp, Dept Cardiol, Yamashina-ku, Kyoto 6078062, Japan
关键词
catheterization; chronic limb-threatening ischemia; critical limb ischemia; infection; wound healing; IN-STENT RESTENOSIS; DRUG-COATED BALLOON; PACLITAXEL-ELUTING BALLOON; SUPERFICIAL FEMORAL-ARTERY; LASER ATHERECTOMY; STANDARD BALLOON; EXCIMER-LASER; ANGIOPLASTY; METAANALYSIS; TRIAL;
D O I
10.1177/15266028221134890
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objectives: This study aimed to evaluate the relationship between bacteriological findings and wound healing after minor amputation in the treatment of chronic limb-threatening ischemia (CLTI) with infection. Methods: This single-center retrospective study analyzed 135 consecutive limbs with tissue loss and infection from 120 patients who underwent endovascular therapy (EVT) and minor forefoot amputation for CLTI with wound infection between November 2017 and August 2021. The Kaplan-Meier method was used to assess the rate of wound healing after the procedure. The Cox proportional-hazards model was used to examine the impact of bacteriological findings and baseline characteristics on wound healing. Results: The wound healing rate at 6 months was 72.6%. In a multivariate analysis, in addition to hemodialysis (hazard ratio [HR]=1.73; p=0.009) and amputation above the metatarsophalangeal (MP) joint (HR=1.81; p=0.006), antimicrobial-resistant bacterial infection (HR=1.80, p=0.004) and polymicrobial infection (H=1.51; p=0.049) were predictors of delayed wound healing. Conclusion: Antimicrobial-resistant bacterial infection, polymicrobial infection, hemodialysis, and amputation above the MP joint were independent predictors of delayed wound healing after EVT and minor forefoot amputation in patients with CLTI and bacterial wound infection. Clinical Impact In this single-center retrospective study, we analyzed 136 consecutive limbs with tissue loss and infection from 120 patients who underwent endovascular therapy and minor forefoot amputation for chronic limb-threatening ischemia (CLTI) with wound infection between November 2017 and August 2021. Our main findings were that antimicrobial-resistant bacterial infection, polymicrobial infection, hemodialysis, and amputation above the metatarsophalangeal joint were independent predictors of delayed wound healing after minor amputation. This is the first report of the association between bacteriological studies and wound healing in CLTI with infection, and will be of great help in the future clinical practice.
引用
收藏
页码:450 / 456
页数:7
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