Abstract：
BACKGROUND:The objective of this study was to compare the outcome of patients presenting with heel ulcers or gangrene (HEEL group) with those having lesions in other parts of the foot (non-HEEL group). METHODS:Treatment and outcomes of all HEEL and non-HEEL patients between June 2001 and October 2006 were compared. RESULTS:Three hundred eight patients were treated (71 HEEL and 237 non-HEEL). The HEEL group was more frequently nonambulatory, had lower albumin levels, and had gangrene. The primary amputation rate (11% vs 3%, P < .001) was higher in HEEL patients, and more endovascular interventions were also performed in the HEEL group (75% vs 55%, P = .015). The 24-month limb salvage and patency rates were similar; but survival was worse in HEEL patients. Serum albumin <3 g/dL, dialysis dependence, and gangrene were associated with limb loss in the HEEL group. Mean time to healing was 4.3 +/- 3.4 months. CONCLUSIONS:Patients with ischemic heel ulcers or gangrene were more likely to undergo primary amputation; however, limb salvage rates were similar to those of non-HEEL patients after attempted salvage. Endovascular interventions currently play a significant role in the management of these patients. Gangrene, serum albumin <3 g/dL, and dialysis dependence resulted in increased limb loss in patients with ischemic heel lesions.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Dosluoglu HH,Attuwaybi B,Cherr GS,Harris LM,Dryjski MLdoi
10.1016/j.amjsurg.2007.08.008subject
Has Abstractpub_date
2007-11-01 00:00:00pages
600-5issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00650-2journal_volume
194pub_type
杂志文章abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：:Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90010-6
更新日期：1976-05-01 00:00:00
abstract：BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2002.10.002
更新日期：2004-01-01 00:00:00
abstract：:Definitive therapy for variceal hemorrhage has evolved during the past half century. Only completely decompressing shunts (nonselective shunts) were available before 1967. Additional options now include selective shunts, devascularization procedures, endoscopic sclerotherapy, pharmacotherapy, and hepatic transplantati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80873-6
更新日期：1990-07-01 00:00:00
abstract：:Gastric restrictive surgery has evolved over the past decade as the treatment of choice for morbid obesity. We reviewed our experience with 289 patients who underwent gastric surgery for morbid obesity. Comorbid diseases included respiratory insufficiency in 19 percent of the patients, hypertension in 36 percent, diab...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90438-8
更新日期：1989-01-01 00:00:00
abstract：:Meckel's diverticulum is the most common congenital abnormality of the small intestine, occurring in about 2 per cent of the population. Complications of a Meckel's diverticulum, including hemorrhage, inflammation, bowel obstruction, and neoplasms, occur in 15 to 33 per cent of cases and invariably demand operative tr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90345-1
更新日期：1975-06-01 00:00:00
abstract：:Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90095-8
更新日期：1978-02-01 00:00:00
abstract：:A safe and rapid technic for internal jugular vein cannulation is described. The success rate is almost as high and the serious complication rate is much lower than subclavian vein cannulation. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90148-4
更新日期：1978-05-01 00:00:00
abstract：BACKGROUND:Surgical coaching, with the goal of improving operative performance, has been introduced into residency and fellowship programs. This is the first systematic review on surgical coaching limited to randomized controlled trials. The objective of this review is to synthesize the existing evidence that addresses...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.05.003
更新日期：2018-07-01 00:00:00
abstract：OBJECTIVE:To demonstrate chest roentgenograms after central venous line changes over a guidewire delay the use of the central lines and increases charges with no change of morbidity or the rate of complication. METHODS:Retrospective study using the Surgical Intensive Care database followed by a nonrandomized, prospect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00142-1
更新日期：1998-09-01 00:00:00
abstract：:The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90433-7
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.050
更新日期：2006-12-01 00:00:00
abstract：:We compared the prevalence of stroke and death in 133 patients aged 75 and older in whom 170 carotid endarterectomies were performed with that in 501 patients less than age 75 in whom 640 carotid endarterectomies were performed. There were three strokes (2%) in patients aged 75 and older and nine strokes (1%) in young...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80753-6
更新日期：1990-12-01 00:00:00
abstract：:This article is a textual record of the Presidential Address from the Association of Women Surgeons Annual Conference in 2020. This year (2020) has been a tumultuous year exposing inequities in Surgery and health care. Even during these challenging times, the ability to sculpt our future rests in our hands. We will do...
journal_title：American journal of surgery
pub_type： 社论
doi：10.1016/j.amjsurg.2020.10.001
更新日期：2020-11-01 00:00:00
abstract：:Distal embolization of fragmented laminated thrombus and atheroma producing peripheral ischemia or gangrene is an underemphasized complication of arterial reconstruction. A set of techniques has been developed to minimize this important complication. To assess their effectiveness, the incidence of distal embolism in p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90293-9
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:Prognosis after resection for intrahepatic cholangiocarcinoma (ICC) remains unsatisfactory. There remains no effective therapy after recurrent ICC. OBJECTIVE:The current study sought to evaluate risk factors associated with recurrent ICC and possible therapies after resection. METHOD:A review of data from ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.12.035
更新日期：2011-02-01 00:00:00
abstract：:1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90490-0
更新日期：1975-10-01 00:00:00
abstract：:In an effort to assess the impact of enhanced macrophage function in acute pancreatitis, mice were subjected to a choline-deficient diet supplemented by ethionine to induce necrotizing pancreatitis. Treatment with the macrophage stimulant glucan resulted in improved survival rates (58 percent versus 14 percent) and ma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90197-8
更新日期：1987-01-01 00:00:00
abstract：:Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90402-x
更新日期：1975-09-01 00:00:00
abstract：:A 24-year-old woman with no significant past medical or surgical history presented with diffuse abdominal pain and distention with decreased frequency of bowel movements for 1 month. A computerized tomography scan showed a massively dilated cecum suggesting obstruction. Exploratory laparotomy revealed bowel obstructio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.10.030
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(99)80206-2
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND:This study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior. METHODS:Nine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common proced...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.018
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Hemoglobin-based blood substitutes appear poised to deliver the promise of a universally compatible, disease-free alternative to banked blood. However, vasoconstriction following administration of tetrameric hemoglobins has been problematic, likely because of nitric oxide binding. Polymerized hemoglobin is e...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(98)00275-x
更新日期：1998-12-01 00:00:00
abstract：:The technique of intraoperative autotransfusion utilizing the Haemonetics Cell Saver is described. This device separates and washes red blood cells removed from the surgical field. Advantages of this unit over others are (1) no systemic anticoagulation is required, (2) circulatory fibrin debris is removed, (3) plasma ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90390-1
更新日期：1981-10-01 00:00:00
abstract：BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00242-1
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00054-2
更新日期：1996-07-01 00:00:00
abstract：BACKGROUND:The unpredictability of prosthetic vascular access thrombosis precludes the scheduling of elective graft thrombectomy. This results in inconsistent dialysis for patients, as well as logistical challenges for dialysis clinics and surgeons, and increased cost. In an effort to solve this problem a community-wid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00133-6
更新日期：1999-08-01 00:00:00
abstract：:In a 2 year period, 60 consecutive feeding enterostomies were placed in malnourished patients. The major complication rate was 1.6 percent. Total complications were 8 percent. Thirty day mortality was 13 percent. Nearly all patients were given isosmotic nonelemental diets. The incidence of diarrhea was 2 percent with ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80102-1
更新日期：1985-03-01 00:00:00
abstract：:With the aid of ultrasonography, representative percutaneous biopsy specimens were obtained from 20 of 21 patients (95 percent) with liver metastases of carcinoids and endocrine pancreatic tumors. The specimens were examined with silver stains and immunocytochemically after the application of monoclonal serotonin anti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90470-7
更新日期：1984-09-01 00:00:00
abstract：BACKGROUND:To evaluate the clinical and laboratory characteristics of patients submitted to subtotal splenectomy during the immediate and late postoperative period. METHODS:The study was conducted on 34 patients, 25 of whom were submitted to subtotal splenectomy (group I), and 9 to total splenectomy without preservati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01407-1
更新日期：2003-04-01 00:00:00
