Mii Shinsuke, Guntani Atsushi, Kawakubo Eisuke, Tanaka Kiyoshi, Kyuragi Ryoichi
Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu City, Japan.
Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu City, Japan.
Ann Vasc Surg. 2018 May;49:30-38. doi: 10.1016/j.avsg.2017.11.039. Epub 2018 Feb 15.
Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss.
Two hundred sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into 2 groups based on whether or not cilostazol was administered after surgery. The end point was wound healing. The 1-year outcomes of the groups were analyzed using the Kaplan-Meier method, and a propensity score matching analysis was performed to examine the effects of cilostazol on wound healing. In addition, the significant predictors were determined using a Cox proportional hazards regression analysis.
Sixty-one and 202 limbs were included in the cilostazol and non-cilostazol group, respectively. The cilostazol group showed superior wound healing to the non-cilostazol group (cilostazol versus non-cilostazol, 1-year wound healing rate: 92% vs. 81%; median wound healing time: 45 vs. 78 days, P = 0.002). The results of the cilostazol group remained superior after a propensity score matching (cilostazol versus non-cilostazol, 1-year wound healing rate: 95% vs. 83%; median wound healing time: 45.5 vs. 57 days, P = 0.048). A Cox proportional hazards regression analysis indicated that foot infection, Rutherford classification, diabetes mellitus, coronary artery disease, angiosome, the administration of cilostazol, and graft patency were significant factors that influenced wound healing.
The postoperative use of cilostazol help to promote wound healing after open surgery.
很少有报告描述药物对血管重建术后缺血性溃疡伤口愈合的影响。本研究旨在调查西洛他唑对因缺血性组织丢失而接受股腘动脉旁路移植术患者伤口愈合的影响。
将2004年1月至2015年12月因组织丢失而首次接受股腘动脉旁路移植术的263条肢体，根据术后是否使用西洛他唑分为两组。终点指标为伤口愈合。采用Kaplan-Meier法分析两组的1年结局，并进行倾向评分匹配分析以检验西洛他唑对伤口愈合的影响。此外，使用Cox比例风险回归分析确定显著预测因素。
西洛他唑组和非西洛他唑组分别纳入61条和202条肢体。西洛他唑组的伤口愈合情况优于非西洛他唑组（西洛他唑组与非西洛他唑组，1年伤口愈合率：92%对81%；中位伤口愈合时间：45天对78天，P = 0.002）。倾向评分匹配后，西洛他唑组的结果仍然更好（西洛他唑组与非西洛他唑组，1年伤口愈合率：95%对83%；中位伤口愈合时间：45.5天对57天，P = 0.048）。Cox比例风险回归分析表明，足部感染、卢瑟福分级、糖尿病、冠状动脉疾病、血管体、西洛他唑的使用以及移植物通畅情况是影响伤口愈合的重要因素。
术后使用西洛他唑有助于促进开放手术后的伤口愈合。
