title: Preliminary experiences with early primary closure of foot wounds after lower extremity revascularization.
abstract: BACKGROUND
  The costs associated with local wound care after revascularization can be significant, and it has been suggested that early closure or healing of foot wounds can be a source of cost savings. We sought to determine the safety and effectiveness of attempts to primarily close chronic foot wounds early after revascularization.
  
  
  METHODS
  We performed a single-center 1-year review of patients who underwent primary wound closure during the same hospitalization as revascularization.
  
  
  RESULTS
  Seven patients underwent an attempt at early primary wound closure. Most (71%) were diabetic. The wounds were primarily closed at a median of 6 days after revascularization (range 3-8 days). The limb-salvage rate at 6 months was 86%. Four patients remained completely healed with primary closure. One healed secondarily with wound care, and 2 required major amputation. Wound-closure techniques included the use of toe/forefoot amputations, skin grafting, and local flaps.
  
  
  CONCLUSIONS
  Early primary closure after revascularization may be a safe technique to consider for carefully selected foot wounds without ongoing soft tissue infection.
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. Electronic address: nbarshes@bcm.tmc.edu.
authors.forename: Neal R
authors.initials: NR
authors.lastname: Barshes
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Bechara
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: George
authors.initials: G
authors.lastname: Pisimisis
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: Panos
authors.initials: P
authors.lastname: Kougias
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000175:diagnosis / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D016038:Skin Transplantation; D013524:Surgical Flaps; D013781:Texas; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D058106:Wound Closure Techniques / Q000009:adverse effects; D014945:Wound Healing