Volume : 5, Issue : 2, February - 2016

Pedicled omentoplasty in lower limb for ischemic ulcers

Bhavinder Arora

Abstract :

<p><p>&nbsp;Background: Ischemic leg ulcers are due to critical ischemia of the lower extremity. The peripheral vascular diseases like atherosclerosis, thromboangitis obliterans, and diabetes. Restriction of blood flow due to arterial stenosis or occlusion leads to complaint of intermittent claudication, rest pain, ulceration and gangrene. For healing of ischemic ulcers and limb salvage a revascularization procedure is a must. Pedicled omentoplasty is the procedure of choice which can be performed by general surgeon. Material and Methods: The closed pedicled omentoplasty was done in 20 patients. Among them 15 patients had thromboangitis oblterans, 3 patients had atherosclerotic ischemia and 2 patients had diabetic ischemia. Diabetes was well controlled but the patients were suffering from hypertension. The tailoring of omentum was done after exploratory laparotomy. The omentum reached at least calf muscle by subcutaneous tunnelling. Result: Improvement in local skin temperature, measurement of oxygen saturation by pulse oximetry in pre and post operative period, ankle anchial pressure index occurred in all the patients. Symptomatic improvement in form of rest pain occurred in all patients. Healing of ulcers and amputation site occurred in all the patients. The patients were assessed on 7th day, 14th day and one month and three months for healing of ischemic ulcers. The healing time for ulcers varied from 3 to 6 weeks. Conclusion: This revascularization procedure can be done by general surgeon for limb salvage and healing of ischemic ulcers.</p></p>