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FREE VERSUS PEDICLED OMENTAL GRAFTS FOR LIMB SALVAGE IN BUERGER'S DISEASE
Author(s) -
Talwar S.,
Jain S.,
Porwal R.,
Laddha B. L.,
Prasad P.
Publication year - 1998
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1998.tb04634.x
Subject(s) - medicine , buerger's disease , surgery , amputation , claudication , intermittent claudication , rest (music) , second toe , transplantation , disease , vascular disease , arterial disease
Background : Buerger's disease is a disabling and progressive disease that affects young smokers with a variable and unpredictable course. Free or pedicled omental transfer are the possible modes of management for these patients, and these modes are compared in the present study. Methods : Of the 43 patients who had Buerger's disease who were treated at the Department of Surgery, Jawahar Lai Nehru (JLN) Hospital, Ajmer, between January 1990 and December 1995, 15 patients underwent application of free omental grafts (group A); 28 patients underwent pedicled omental transplantation (group B). The clinical results obtained with the use of either technique were compared. Results : There were no statistically significant differences in the relief of intermittent claudication (80% v.v 82%), rest pain (82% vs 91%), coldness (83% vs 87%), discolouration (80% vs 82%), ulceration (75% vs 78%) and post‐amputation ulcer healing (75% vs 86%) in the two groups ( P > 0.05); but the time taken for the relief of intermittent claudication, rest pain and coldness was significantly less in group B. Major amputations were not required in both the groups. Conclusions : These findings suggest that the ultimate clinical benefits obtained with the use of either free or pedicled omental grafts in patients with Buerger's disease are similar, supporting a possible local action of the omentum.