Arterial Interventions and Peripheral Arterial Disease (PAD)

Session: Educational Exhibit Presentations - Station 1: Arterial Interventions and Peripheral Arterial Disease (PAD)

Basics of Lower Extremity Wound Evaluation and Management

Monday, March 6, 2023

5:55 PM – 6:00 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Alexander Andrew Argame, BSN, RN (he/him/his)

Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Kevin Zhou, BA

Medical Student
Kaiser Permanente School of Medicine
Anthony R. Zamary, MS

Medical Student
Kaiser Permanente School of Medicine
WG

William Gombrich, BS

Medical Student
Kaiser Permanente School of Medicine
Kartik Kansagra, MD

Vascular and Interventional Physician
KP VISLA
GV

Geogy Vatakencherry, MD, FSVM,FSIR

Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician
AB

Alok Bhatt, MD

Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente Los Angeles

Disclosure(s):

Alexander Andrew Argame, BSN, RN: No financial relationships to disclose

Kevin Zhou, BA: No financial relationships to disclose

Anthony R. Zamary, MS: No financial relationships to disclose

Kartik Kansagra, MD: No financial relationships to disclose

Geogy Vatakencherry, MD FSIR: No financial relationships to disclose

Learning Objectives:

Detail the Wound, Ischemia, and Foot Infection (WiFi) Classification system

Demonstrate a systemic method of lower extremity wound evaluation

Highlight physical exam and laboratory findings that help differentiate chronic ischemic changes from acute infectious changes

Differentiate debridement and dressing options for wound management

Background: Outcomes of patients with chronic limb-threatening ischemia depends on wound management. Because poor wound management following revascularization can lead to limb loss, wounds must be systematically evaluated, debrided, and dressed to promote maximum change of wound healing and limb salvage.

Clinical Findings/Procedure Details:

This exhibit will:

Review the Wound, Ischemia, and Foot Infection (WiFi) Classification system and its significance to determine potential for wound healing and amputation risk

Discuss physical exam findings, Erythrocyte Sedimentation Rate and C-Reactive Protein blood tests, and radiographs to guide evaluation of wounds

Compare and contrast wound debridement strategies including irrigation, surgical intervention, enzymatic method, and biologic method.

Compare and contrast wound dressing options for various stages of wound healing including polymers, foams, alginates, hydrocolloids, hydrogels, and Hydroactive.

Conclusion and/or Teaching Points:

Evaluation and management of lower extremity wounds is essential, especially in patients with peripheral artery disease, chronic limb-threatening ischemia, or other risk factors for limb loss. Proper wound care, with appropriate debridement and dressing especially, is an essential component to healing following revascularization. Furthermore, routine evaluation of wounds ensures the outcome of revascularization is satisfactory and establishes whether additional intervention is required.