الفهرس 
SURGICAL ANATOMY AND ACCESSOnly 14 pages are availabe for public view
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Abstract
Background: Because of delayed healing duration of variable foot wounds, techniques for identifying methods to expedite wound healing process were needed. Angiosome concept divides the foot into three-dimensional zones of tissue supplied by specific arterial source.
Patients and Methods: Our study included 40 patients (40 limbs) presenting with Rutherford class (5 and 6) foot wounds, with infrapopliteal arterial disease without significant proximal arterial disease with good run in and run off tibial segments and patent foot arch underwent successful primary tibial angioplasty, patients were collected from January 2018 till June 2018 and were followed up within two years from July 2018 till July 2020 for the impact of angiosome-directed angioplasty on wound healing and limb salvage rates.
Results: Direct angiosomal arterial flow to the wound zone was accomplished in 27 patients (67.5%) with better and faster wound healing rate 1.4 months (SD 0.41) and high limb salvage rate, compared to indirect non-angiosomal arterial flow was accomplished in 13 patients (32.5%) with delayed wound healing rate 7.8 months (SD 1.7) and low limb salvage rate. Age, gender, and different comorbitities were statistically insignificant in wound healing rates.
Conclusion: The study established that direct angiosomal tibial angioplasty had a considerable role in improving foot wound healing rate with higher limb salvage rate than the indirect non-angiosomal tibial angioplasty. Obtaining direct arterial supply based on the angiosome technique of perfusion to different foot ulcers or post minor toes amputation ulcer (gangrenous toes) seemed to be significant for wound healing rates in critical limb ischemia patients.