Preliminary Experiences with Early Primary Closure of Foot Wounds after Lower Extremity Revascularization

Abstract

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. We performed a single-center 1-year review of patients who underwent primary wound closure during the same hospitalization as revascularization. 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. Early primary closure after revascularization may be a safe technique to consider for carefully selected foot wounds without ongoing soft tissue infection.