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Pedicled omental transfer for limb salvage in Buerger's disease
1Department of General Surgery, Jawahar Lal Nehru Medical College and Hospital, Ajmer (Rajasthan), India. sachintalwar@hotmail.com
Insights
Pedicled omental transfer effectively treated limb ischemia in Buerger's disease patients, significantly improving symptoms and preventing amputations. This surgical technique offers promising limb salvage outcomes.
Area of Science:
- Vascular Surgery
- Regenerative Medicine
Background:
- Buerger's disease is a severe vascular condition causing limb ischemia.
- Limb ischemia in Buerger's disease often leads to debilitating pain and potential amputation.
Purpose of the Study:
- To evaluate the efficacy of pedicled omental transfer in treating limb ischemia.
- To assess the impact of this procedure on patient symptoms and limb salvage.
Main Methods:
- Pedicled omental transfer was performed on 62 male patients with Buerger's disease and limb ischemia.
- Outcomes including symptom relief, tissue oxygen saturation, and claudication distance were monitored.
Main Results:
- High rates of symptom relief were observed: 92% for intermittent claudication, 94% for rest pain, 83% for limb coldness, 82% for discolouration, and 83% for ulcer healing.
- Tissue oxygen saturation improved significantly, and claudication distance increased from 75m to 1000m.
- No major amputations were required, indicating successful limb conservation.
Conclusions:
- Pedicled omental transfer is a promising surgical option for limb salvage in Buerger's disease.
- The procedure demonstrates significant clinical benefits and improved limb perfusion.
Abstract:
We performed pedicled omental transfer in 62 patients with Buerger's disease at the Department of Surgery, J.L.N. Hospital, Ajmer between January 1990 and December 1996. All were male and had evidence of limb ischaemia. Post-operative results in these patients consisted of relief of intermittent claudication in 92%, disappearance of rest pain in 94%, disappearance of limb coldness in 83%, disappearance of discolouration in 82%, and healing of ischaemic ulcers in 83%. Tissue oxygen saturation in the affected limb improved from a mean of 84.8+/-3.6% in the preoperative period, to 89+/-1.5% at 12 h, 93.1+/-1.8% at 72 h and 96+/-1.2% at the end of 2 months of follow-up. Claudication distance improved from a mean of 75+/-20 m in the pre-operative period to 1000+/-110 m at 2 months of follow-up in 57 of 62 patients. Major amputations were not required in any patient, thus conserving the limb. We conclude that pedicled omental transfer offers promising results in patients with limb ischaemia due to Buerger's disease.
