A retrospective review identified 142 patients with chronic nonhealing ulcers on 169 limbs who were referred to the University of North Carolina Wound Management Center from January 1999 to March 2005 and who were not treated with revascularization. The mean age of the patients was 70.8 years (range, 38-93), 83 were male, and 100 had diabetes mellitus. All patients underwent a noninvasive Doppler evaluation of arterial supply, ankle and toe blood pressure was measured, and the ankle-brachial index (ABI) was calculated. Those with an ABI of < 0.70 or a toe pressure of < 50 mmHg were considered to have arterial insufficiency. Those with an ankle pressure < 70 mmHg or a toe pressure < 40 mmHg were considered to have critical limb ischemia. Many of the patients had severe cardiac dysfunction, were nonambulatory, or had inadequate outflow vessels, but the group also included a few patients who simply refused revascularization. Patients were not included in the study if they had a Wagner grade 5 wound, a Wagner grade 4 wound with extensive tissue loss, or a necrotizing infection so severe that antibiotic therapy and debridement would not yield a salvageable foot. Healing was defined as complete epithelial coverage with no drainage. Follow-up was 18 months.
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机译：一项回顾性研究确定了从1999年1月至2005年3月转诊至北卡罗来纳大学伤口管理中心且未接受血管重建治疗的169例肢体慢性溃疡的142例患者。患者的平均年龄为70.8岁（范围38-93岁），其中男性83位，糖尿病100位。所有患者均接受了无创多普勒动脉供血评估，测量了脚踝和脚趾的血压，并计算了踝肱指数（ABI）。 ABI <0.70或脚趾压力<50 mmHg的患者被认为患有动脉功能不全。踝关节压力<70 mmHg或脚趾压力<40 mmHg的患者被认为患有严重的肢体缺血。许多患者患有严重的心功能不全，不能行走或流出血管不足，但该组患者中还包括一些拒绝血管重建的患者。如果患者的Wagner 5级伤口，Wagner 4级伤口具有广泛的组织丢失或坏死性感染严重到以至于抗生素治疗和清创术不会产生可救治的脚，则不包括在研究中。愈合定义为完全上皮覆盖，无引流。随访18个月。
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