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Atenção Primária à Saúde

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Preliminary experiences with early primary closure of foot wounds after lower extremity revascularization.

Barshes, Neal R; Bechara, Carlos F; Pisimisis, George; Kougias, Panos.
Ann Vasc Surg; 28(1): 48-52, 2014 Jan.
Artigo em Inglês | MEDLINE | 2014 | ID: mdl-24189006
Resumo: BACKGROUND: The costs associated with local wound care after revascularization can be significant, and it has been suggested that early closure or healing of foot wounds can be a source of cost savings. We sought to determine the safety and effectiveness of attempts to primarily close chronic foot wounds early after revascularization. METHODS: We performed a single-center 1-year review of patients who underwent primary wound closure during the same hospitalization as revascularization. RESULTS: Seven patients underwent an attempt at early primary wound closure. Most (71%) were diabetic. The wounds were primarily closed at a median of 6 days after revascularization (range 3-8 days). The limb-salvage rate at 6 months was 86%. Four patients remained completely healed with primary closure. One healed secondarily with wound care, and 2 required major amputation. Wound-closure techniques included the use of toe/forefoot amputations, skin grafting, and local flaps. CONCLUSIONS: Early primary closure after revascularization may be a safe technique to consider for carefully selected foot wounds without ongoing soft tissue infection.