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Two-staged amputation in unsalvageable limbs, guillotine followed by closure, in patients with peripheral arterial disease and/or severe foot infections: retrospective review of cases

Grant number: 12/15563-8
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): February 01, 2013
Effective date (End): January 31, 2014
Field of knowledge:Health Sciences - Medicine - Surgery
Principal Investigator:Winston Bonetti Yoshida
Grantee:Leandro Ramos e Silva
Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


The peripheral arterial disease (PAD) is a serious chronic condition that mainly affects elderly patients with risk factors for atherosclerosis. The progression to critical limb ischemia is characterized by rest pain, ischemic ulcers or gangrene, which occurs in about 5-10% of cases, and may progress to amputation in 1.0 to 3.3%. Particularly in the diabetics, the PAD may be associated with severe infections in the lower extremities, with difficult rescue of their limbs. A large number of patients arrive at the vascular surgery services in advanced stages of infection in the extremities, with associated risk of septicemia and death, which imposes the need for immediate amputation in these cases. An alternative for these patients is the strategy of two-staged amputation: the first, in guillotine, to drain the infection and the second, closed, in a more proximal level, after controlling the infectious process. This approach use to reduce the risk of failure in the second amputation, the risk of amputations at higher levels, the frequency of review of stumps and mortality. Therefore, the objective of this study is to evaluate retrospectively the primary healing rate of the second amputation and the time between the both amputations and also: demographic profile, morbid past and the presented conditions of the affected limb in consecutive patients of our University Hospital in the period January 2007 to December 2011. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SILVA, LEANDRO RAMOS; FERNANDES, GIORDANO MASINI; MORALES, NATACHA UEDA; SOBREIRA, MARCONE LIMA; MOURA, REGINA; BERTANHA, MATHEUS; YOSHIDA, WINSTON BONETTI. Results of One-Stage or Staged Amputations of Lower Limbs Consequent to Critical Limb Ischemia and Infection. ANNALS OF VASCULAR SURGERY, v. 46, p. 218-225, . (13/16724-8, 12/15563-8)

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