Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia

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Antonopoulos , C N , Lazaris , A , Venermo , M & Geroulakos , G 2019 , ' Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia ' , Vascular and Endovascular Surgery , vol. 53 , no. 8 , 1538574419868863 , pp. 649-657 . https://doi.org/10.1177/1538574419868863

Title: Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia
Author: Antonopoulos, Constantine N.; Lazaris, Andreas; Venermo, Maarit; Geroulakos, George
Contributor: University of Helsinki, Verisuonikirurgian yksikkö
Date: 2019-11
Language: eng
Number of pages: 9
Belongs to series: Vascular and Endovascular Surgery
ISSN: 1538-5744
URI: http://hdl.handle.net/10138/320949
Abstract: Objectives: After surgical or endovascular revascularization, some ischemic lesions will not heal, while some others will heal at a variable period of time from the intervention, indicating a multifactorial interaction between local and systematic "wound healing-promoting" factors. Our objective was to identify predictors of wound healing following revascularization for chronic limb-threatening ischemia (CLTI). Methods: A literature review was performed to identify published research concerning clinical, biochemical, and noninvasive methods as predictors of wound healing time and wound-free period after surgical and endovascular revascularization for CLTI. Results: Our review indicated that potential predictors included local wound factors, wound depth, patient's comorbidities, medications, smoking and alcohol abuse, poor vessel runoff, and direct versus indirect revascularization. Among the clinical biomarkers, platelet-derived growth factor, transforming growth factor beta, basic fibroblast growth factor, tumor necrosis factor alpha, interleukin (IL) 1, and IL-6 have been proposed as potential predictors. Furthermore, the potential of noninvasive microcirculation assessment to predict proper wound healing has been the topic of extensive investigation. Among the novel methods, transcutaneous measurement of oxygen partial pressure, skin perfusion pressure, oxygen-to-see method, indocyanine green fluorescence imaging, and multispectral optoacoustic tomography have shown promising results. Conclusions: The risk factor profile of an ischemic lesion in the lower extremities with a delayed/failed healing response, following a successful revascularization, is not fully clarified. Although many predictors have been assessed so far, further research needs to be done to identify the optimal clinical and biochemical indices and the noninvasive technique assessing the microcirculation that is associated with complete wound healing.
Subject: wound healing
revascularization
chronic limb-threatening ischemia
biomarkers
HYPERBARIC-OXYGEN THERAPY
DIABETIC FOOT
ENDOVASCULAR REVASCULARIZATION
INFRAINGUINAL BYPASS
BALLOON ANGIOPLASTY
TISSUE LESIONS
SURGERY
ULCERS
INFECTION
OUTCOMES
3126 Surgery, anesthesiology, intensive care, radiology
3121 Internal medicine
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