Elective foot surgery in limbs with arterial disease

Area of Science:

• Vascular Surgery
• Podiatric Surgery
• Arterial Disease Assessment

Background:

• Surgical correction of foot deformities aims to alleviate disability.
• Arterial disease raises concerns about post-operative wound healing, potentially delaying necessary surgeries.
• Pre-operative vascular assessment is crucial for patients undergoing elective foot surgery.

Purpose of the Study:

• To evaluate the safety and healing outcomes of elective foot surgery in patients with pre-existing arterial disease.
• To determine if significant arterial obstruction precludes successful wound healing after foot surgery.
• To establish a method for assessing healing potential in limbs with compromised arterial circulation.

Main Methods:

• Vascular assessment of 23 patients prior to elective foot surgery.
• Categorization of limbs based on evidence of arterial disease (none vs. complete obstruction).
• Utilized laboratory methods including distal blood pressure, skin temperature, transcutaneous oxygen tension, and digital pulsatility.

Main Results:

• 15 limbs showed little to no arterial disease.
• 8 limbs demonstrated complete obstruction of the main limb artery.
• All eight limbs with arterial obstruction healed without complications, indicating the disease was not severe enough to prevent healing.

Conclusions:

• Elective foot surgery can be safely performed in select patients with arterial obstruction.
• Simple laboratory assessments of arterial circulation are valuable for predicting healing outcomes.
• A clinical and laboratory-based approach can estimate healing success in patients with arterial compromise undergoing foot surgery.