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Inflammatory Response II: Inflammatory Exudate and Tissue Repair

Inflammatory Response II: Inflammatory Exudate and Tissue Repair

The immune system's inflammatory response destroys the invading pathogen, permitting the tissue to heal. The changes during the cellular and vascular stages allow exudate formation at the site of inflammation. The inflammatory exudate released from the wound has high protein content and a specific gravity above 1.020.
The typical wound exudate is odorless, transparent, straw-colored, thin, and watery. Exudate, however, can differ depending on the state of wound healing. Likewise, the...

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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

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Predictive value of the inflammatory indices on wound healing in patients with chronic limb-threatening ischemia

Yeliz Guler¹, Omer Genc¹, Furkan Akbas²

¹Department of Cardiology, Basaksehir Cam & Sakura City Hospital, University of Health Sciences, Istanbul, Turkey.

Vascular Medicine (London, England)

|March 3, 2025

Summary

Inflammatory markers like the systemic inflammation response index (SIRI) can predict wound healing in patients with chronic limb-threatening ischemia (CLTI) after endovascular therapy (EVT). Higher SIRI values indicate a lower likelihood of successful wound healing.

Keywords:

Naples prognostic score (NPS)chronic limb-threatening ischemia (CLTI)pan-immune inflammatory value (PIV)peripheral artery disease (PAD)systemic immune-inflammation index (SII)systemic inflammation response index (SIRI)wound healing

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Assessment of Acute Wound Healing using the Dorsal Subcutaneous Polyvinyl Alcohol Sponge Implantation and Excisional Tail Skin Wound Models.

Published on: March 25, 2020

Area of Science:

Vascular Surgery
Inflammation Research
Atherosclerosis Complications

Background:

Peripheral artery disease (PAD) is a common manifestation of atherosclerosis, often leading to chronic limb-threatening ischemia (CLTI).
Endovascular therapy (EVT) is effective but patient prognosis can remain poor.
Investigating inflammatory markers' role in wound healing for Fontaine stage 4 CLTI patients is crucial.

Purpose of the Study:

To investigate the relationship between specific inflammatory indices and wound healing outcomes in patients with Fontaine stage 4 CLTI undergoing EVT.
To evaluate the predictive performance of various inflammatory scores for wound healing.
To identify the most potent inflammatory predictor for successful wound healing post-EVT.

Main Methods:

Retrospective analysis of 168 patients (185 extremities) with Fontaine stage 4 CLTI treated with EVT from June 2021 to January 2024.
Calculation of Naples prognostic score (NPS), pan-immune inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI).
Utilized discrimination and decision curve analyses to assess the predictive value of inflammatory indices for wound healing.

Main Results:

Wound healing occurred in 76.8% of patients post-EVT.
Higher NPS, PIV, SII, and SIRI were associated with nonhealing extremities.
NPS, PIV, SII, and SIRI were independently predictive of wound healing, with SIRI demonstrating the strongest predictive ability (AUC = 0.840).

Conclusions:

Inflammatory indices including SIRI, SII, PIV, and NPS can predict wound healing potential in CLTI patients post-EVT.
SIRI emerged as the most significant predictor of wound healing in this patient cohort.
These markers may aid in in-hospital follow-up and prognostic assessment.