Endovascular Revascularization: A Limb Salvage Strategy After Lower Extremity Burns
Desiree N Pinto1, Isabel Snee2, Saher Sabri3
1Georgetown University School of Medicine, Washington, District of Columbia; Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia.
The Journal of Surgical Research
|August 13, 2025
Summary
Endovascular revascularization improved limb salvage in diabetic burn patients with peripheral artery disease. This technique showed promise for wound healing and limb preservation, reducing major amputations.
Area of Science:
- Vascular Surgery
- Burn Management
- Diabetic Complications
Background:
- Lower extremity burn injuries in diabetic patients frequently lead to wound complications and amputations.
- Endovascular revascularization is a potential treatment for limb salvage in this population but requires evaluation.
Purpose of the Study:
- To describe a burn center's experience with endovascular revascularization in acute lower extremity burn management.
- To evaluate the impact of endovascular revascularization on wound healing and amputation rates in diabetic burn patients.
Main Methods:
- Retrospective review of patients with lower extremity burns and diabetes mellitus undergoing angiography with or without endovascular revascularization.
- Analysis of intraoperative findings, wound healing outcomes, graft success, and amputation levels.
Main Results:
- Angiography identified flow-limiting disease in 16.9% of vessels, with improved foot vessel run-off post-intervention.
- 40% of wounds healed without surgery; 30% required autografting with no significant graft loss.
- A 70% limb salvage rate was achieved, with major amputations occurring in 30% of cases due to infection.
Conclusions:
- Endovascular revascularization effectively addresses peripheral artery disease in burn-injured diabetic patients.
- The procedure demonstrates potential for improved wound healing and limb salvage, with no significant graft loss.
- Prospective studies are necessary to further validate these promising outcomes.
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