Abstract:
OBJECTIVE:Wound complications after major lower extremity amputations (LEAs) are a cause of significant morbidity in vascular surgery patients. Recent publications have demonstrated the efficacy of the closed incision negative pressure dressing at preventing surgical site infections (SSIs); however, there are few data on its use in major LEAs. This study sought to assess if closed incision negative pressure wound therapy (NPWT) would decrease the risk of complications as compared with a standard dressing in patients with peripheral vascular disease undergoing major LEA. METHODS:Fifty-four consecutive patient limbs with a history of peripheral arterial disease underwent below-knee or above-knee amputations. This was a retrospective review of a prospectively maintained database from January 2018 to December 2019, and it included 23 amputations in the NPWT group and 31 amputations in the standard dressing group. NPWT using the PREVENA system was applied intraoperatively at the discretion of the operating surgeon and removed 5 to 7 days postoperatively. The standard group received a nonadherent dressing with an overlying compression dressing. Amputation incisions were assessed and wound complications were recorded. Student's t-test and two-sample proportion z-test were used for statistical analysis. A P value of less than .05 was considered statistically significant. RESULTS:For comorbidities, there was a higher incidence of tobacco use in the NPWT as compared with the standard group (44% vs 13%; P = .011), as well as trends toward increased prior amputations, anemia, hyperlipidemia, and chronic obstructive pulmonary disorder in the NPWT group. For risk factors, there were more dirty wounds in the NPWT as compared with the standard group (52% vs 26%; P = .046). For outcomes, there were fewer wound complications in the NPWT as compared with the standard group (13% vs 39%; P = .037). The types of wound-related complications in the NPWT group included one wound dehiscence with a deep SSI, one superficial SSI, and one incision line necrosis. In the standard group, there were four wound dehiscences with deep SSI, three superficial SSIs, four incision line necroses, and one stump hematoma. The rates of perioperative mortality and amputation revision did not differ significantly between the NPWT and the standard groups (3% vs 4% and 4.3% vs 10%, respectively). CONCLUSIONS:Closed incision NPWT may decrease the incidence of wound complications in vascular patients undergoing major LEA. This held true even among a population that was potentially at higher risk. This therapy may be considered for use in lower extremity major amputations.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Chang H,Maldonado TS,Rockman CB,Cayne NS,Berland TL,Barfield ME,Jacobowitz GR,Sadek Mdoi
10.1016/j.jvs.2020.07.061subject
Has Abstractpub_date
2020-07-21 00:00:00eissn
0741-5214issn
1097-6809pii
S0741-5214(20)31708-0pub_type
杂志文章abstract:OBJECTIVE:To retrospectively assess the therapeutic value of endovascular stenting for treatment of the nutcracker syndrome (NCS) in long-term follow-up and to explore the selection of the size of stents in Chinese patients with NCS. METHODS:From January 2004 to August 2010, 30 patients (two women and 28 men) between ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.007
更新日期:2012-07-01 00:00:00
abstract::As CT scanning has evolved as a reliable clinical tool, the use of angiography in the diagnosis of aortic aneurysmal disease has diminished. Fewer than 25% of patients with aortic aneurysmal disease undergo aortic angiographic evaluation at our institution. A prospective clinical study was undertaken to assess the val...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:Lower limb ischemia-reperfusion results in skeletal muscle mitochondrial alterations, production of reactive oxygen species (ROS), and remote organ impairments that are largely involved in patient prognosis. However, whether ischemia without reperfusion increases ROS production and precedes mitochondrial alte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.100
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy. METHODS:The 2003 to 2013 Agency for Healthcare Research and Quality (AH...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.036
更新日期:2017-07-01 00:00:00
abstract::Complications of medicine are like the sand traps in golf courses. They are regrettable, cannot be completely avoided even by the best, and the real skill lies in solving the problems they present. Dr Al Mighty told a resident to ignore a barely elevated temperature in a postoperative patient. "It is nothing worthy of...
journal_title:Journal of vascular surgery
pub_type: 社论
doi:10.1016/j.jvs.2013.10.068
更新日期:2013-12-01 00:00:00
abstract::Tinnitus and hearing loss can occur in patients with a high-riding abnormal jugular bulb. Jugular vein ligation in selected patients can cure tinnitus and reverse hearing loss. A 39-year-old woman reported a 4-year history of right-sided tinnitus of increasing intensity associated with a mild hearing loss. Extensive e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060248
更新日期:1987-09-01 00:00:00
abstract:PURPOSE:Reconstruction techniques tailored to operative findings were applied to 466 consecutive carotid endarterectomies (CEA) performed on 408 patients over 5 years. The choice of reconstructive technique was based on the extent of the arteriotomy incision required to obtain a complete internal CEA endpoint, the abil...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(93)90018-h
更新日期:1993-01-01 00:00:00
abstract::Recurrent carotid stenosis occurs randomly in approximately 10% of patients undergoing endarterectomy. Previous studies have described several histologic features but have failed to clearly elucidate the pathogenesis of this disorder. To improve our understanding of this disease, we reviewed pathologic lesions from 20...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050280
更新日期:1987-02-01 00:00:00
abstract::We have developed an infection resistant vascular prosthesis by bonding rifampin to Dacron grafts with the use of a collagen matrix release system. The purpose of this study was to determine the efficacy of this antibiotic-bonded graft in resisting infection after an in situ reconstruction of a previously infected pro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992/39117
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:Usually, physicians base their practice on guidelines, but recommendations on the same topic may vary across guidelines. Given the uncertainties regarding abdominal aortic aneurysm (AAA) screening, physicians should be able to identify systematically and transparently developed recommendations. We performed a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2010.10.118
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Hyperhomocysteinemia has been implicated as a causative factor in intimal hyperplasia development. The addition of dietary folate in a hyperhomocysteinemia, carotid endarterectomy rat model is postulated to decrease plasma homocysteine levels and, in turn, reduce post-carotid endarterectomy intimal hyperplasi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117144
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the short-term and long-term results of simultaneous surgical treatment of coexisting abdominal aortic aneurysm and bladder carcinoma. METHODS:A prospective study was carried out to compare patients undergoing simultaneous surgical treatment of abdominal aneurysm and...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.26
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Carotid angioplasty and stenting (CAS) is a percutaneous alternative to carotid endarterectomy (CEA) for treating patients with carotid artery stenosis. This study sought to evaluate whether patients at increased perioperative risk for CEA may be treated with CAS while maintaining equivalent outcomes. METHOD...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.12.049
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:Iliac artery aneurysms are rare but associated with significant morbidity and mortality when ruptured. This study compares recent open and endovascular repairs of iliac aneurysms at a single institution. METHODS:Patients were identified and charts reviewed using ICD-9 and CPT codes for iliac artery aneurysm ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.11.008
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:This report presents the 30-day results of the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial and evaluates the safety and efficacy of ENROUTE Transcarotid NPS (Silk Road Medical Inc, Sunnyvale, Calif), a novel transcarotid neuroprotection...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2015.04.460
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.052
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze the early and late outcomes of patients who require a suprarenal aortic cross-clamp during elective open repair of an abdominal aortic aneurysm (AAA). METHODS:Patients from 1998 to 2012 who required a suprarenal aortic cross-clamp during elective open AAA repair wer...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.04.034
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Repair of saccular aortic aneurysms (SAAs) is frequently recommended based on a perceived predisposition to rupture, despite little evidence that these aneurysms have a more malignant natural history than fusiform aortic aneurysms. METHODS:The radiology database at a single university hospital was searched f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.07.002
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Transcatheter embolization with coils and other agents has been described as a treatment method for type II endoleak after endovascular aortic aneurysm repair (EVAR). Type I endoleak has not been treated commonly with such therapies, although most investigators believe they warrant definitive intervention. Th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00729-8
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Nasogastric tube (NGT) decompression after abdominal surgery is still largely used to prevent nausea and vomiting. However, indications are based more on practice than on studies. Moreover, prolonged NGT decompression can lead to complications. In this prospective and randomized study, we evaluated the effect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2005.06.011
更新日期:2005-10-01 00:00:00
abstract:PURPOSE:This study was performed to determine intra-aneurysm sac pressure of abdominal aortic aneurysm after endovascular aneurysm repair in patients considered successfully treated with aneurysm shrinkage and absence of endovascular leakage. METHODS:In 10 patients with median aneurysm shrinkage of 12 mm (range, 7 to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.138
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:Fenestrated or branched endovascular aortic repair (FB-EVAR) usually represents the last stage in endovascular treatment of postdissection aneurysm after thoracic endograft coverage of entry tear and false lumen embolization. METHODS:The study was a retrospective analysis of all patients with postdissection ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.117
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The main cause of occlusion and vein graft failure after peripheral and coronary arterial reconstruction is intimal hyperplasia. Transforming growth factor beta-1 (TGF-beta1) is a pleiotropic cytokine known to have powerful effects on cell growth, apoptosis, cell differentiation, and extracellular matrix syn...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.01.016
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Treatment of chronic venous insufficiency (CVI) has largely focused on reflux. Minimally-invasive techniques to address superficial and perforator reflux have evolved, but correction of deep reflux continues to be challenging. The advent of intravascular ultrasound (IVUS) scan and minimally invasive venous s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.032
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:A strategy in minimizing thrombotic events of vascular constructs is to seed the luminal surface with autologous endothelial cells (ECs). The task of seeding ECs can be achieved via bioreactors, which induce mechanical forces (shear stress, strain, pressure) onto the ECs. Although bioreactors can achieve a c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.074
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:Outcome with selective or systematic stenting with the Palmaz vascular stent was compared in patients with limb-threatening ischemia or persistent disabling claudication despite medical therapy, with less than 7 cm stenosis or occlusion of the superficial femoral artery. METHODS:This was a multicenter prospect...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mva.2003.155
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Accurate measurements of abdominal aortic aneurysms (AAAs) are required for surgical planning and monitoring over time. We have examined the feasibility of using a three-dimensional (3-D) ultrasound imaging system to derive quantitative measurements of interest from AAAs. METHODS:A normal aorta, a small AAA,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112812
更新日期:2001-04-01 00:00:00
abstract::Giant splenic artery aneurysms are extremely rare entities that have important clinical implications. The size and the natural history pose unique challenges in the management of these lesions. We present one such case that was associated with a primary arteriovenous malformation in the splenic hilum. This is the thir...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2006.06.049
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Vascular smooth muscle cell (SMC) migration is an important component of the development of intimal hyperplasia. Sphingosine-1-phosphate (S-1-P) is a lipid released from activated platelets with numerous cellular effects including the stimulation of SMC migration in vitro. We examined the role of the mammali...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.058
更新日期:2005-01-01 00:00:00
abstract:PURPOSE:Construction of prosthetic arteriovenous access for hemodialysis in the thigh results in a high incidence of graft failure and infection. Autogenous femoral artery-common femoral thigh transposition (transposed femoral vein [tFV]) arteriovenous accesses have superior patency, but our previous report documented ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.10.039
更新日期:2005-02-01 00:00:00