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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

547
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
547

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Chronic Lower Extremity Wounds: Updates on Lower Extremity Reconstruction in Clinics in Plastic Surgery.

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Biomechanical Considerations of the Neuropathic Foot: A Primer for Plastic Surgeons.

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Tibiotalocalcaneal Arthrodesis as a Tool for Podoplastic Limb and Gait Salvage in the Chopart Amputation: A Functional Assessment.

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Improving Limb Salvage Outcomes in Racially and Ethnically Underserved Populations With a Highly Integrated

Nisha J Gupta1, Rachel N Rohrich1, Rajan M Negassa2

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Summary

This study found that free tissue transfer (FTT) for lower extremity (LE) limb salvage yields similar outcomes across racial groups, despite Black patients having more comorbidities and lower socioeconomic status. Multidisciplinary care mitigates disparities.

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Area of Science:

  • Reconstructive surgery
  • Limb salvage surgery
  • Health disparities

Background:

  • Previous studies show racial disparities in lower extremity (LE) limb salvage outcomes and amputation rates.
  • These disparities have not been specifically evaluated in the context of free tissue transfer (FTT) for chronic, nonhealing wounds.

Purpose of the Study:

  • To analyze the outcomes of LE FTT for chronic, nonhealing wounds based on patient race.
  • To identify potential racial disparities in complication rates, amputation, and mortality following LE FTT.

Main Methods:

  • Retrospective review of all LE FTTs performed between 2011 and 2024.
  • Data collected included patient demographics, socioeconomic factors, operative details, and surgical outcomes.
  • Analysis compared outcomes across racial groups: White, Black, and Hispanic or Asian.

Main Results:

  • A total of 335 FTTs were analyzed: 49% White, 45.4% Black, and 5.7% Hispanic or Asian.
  • Black patients exhibited significantly higher rates of comorbidities (diabetes, ESRD, neuropathy) and lower socioeconomic status (income, education).
  • Despite these differences, there were no significant variations in flap complications, postoperative amputations, ambulatory status, or mortality rates among racial groups.

Conclusions:

  • Integrated, multidisciplinary limb salvage approaches achieve favorable outcomes in chronic, nonhealing wounds, irrespective of race.
  • Optimizing patient care and ensuring long-term follow-up can effectively mitigate the impact of socioeconomic factors on surgical outcomes.
  • LE FTT demonstrates comparable success rates across different racial and socioeconomic backgrounds when managed comprehensively.