Abstract
PURPOSE: The objective of this study was to evaluate patients undergoing operative debridement for heel ulceration and to categorize pedal perfusion and its influence on therapeutic alternatives. METHODS: Patients with heel ulceration were stratified by arteriography and graded I (patent posterior tibial, PT), II (occluded PT/reconstituted from peroneal), III (PT reconstituted from dorsal pedal), IV (no PT reconstitution but visible heel tributaries), and V (avascular heel). RESULTS: From May 1992 through January 1997, 23 patients underwent operative treatment for 25 heel ulcers. The heel ischemia score stratified patients into two groups: 1, revascularization/debridement (71% grades I to III, 29% grade IV, 0% grade V); and 2, free tissue transfer with or without revascularization (100% grades IV, V). Cumulative functional limb salvage was 91% (BP), 60% (BP+TT), and 81% (TT) at 24 months (P = 0.15 log rank). CONCLUSION: The heel ischemia score may direct treatment of heel ulceration by identifying patients who will need vascularized tissue transfer early in their treatment regimen.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 109-114 |
| Number of pages | 6 |
| Journal | American journal of surgery |
| Volume | 176 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1998 |
| Externally published | Yes |
ASJC Scopus subject areas
- Surgery
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