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ORIGINAL ARTICLE
Year : 2014  |  Volume : 4  |  Issue : 1  |  Page : 20-24

Evaluation of the role of omental transposition in chronic limb ischemia: A prospective study


1 Department of Surgery, University College of Medical Sciences and GTB Hospital, New Delhi, India
2 Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India

Correspondence Address:
S Saha
Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, New Delhi - 110 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.136705

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Background: Surgical treatment options for thromboangitis obliterans (Burger's disease) and atherosclerosis where arterial reconstruction is not possible are limited. Omental transposition is one of the treatment modalities used in these patients. However, improvement in vascularity of the limb has been infrequently evaluated in previous studies. In this study, we evaluated the outcome of omental transposition in patients with chronic peripheral vascular disease in terms of clinical improvement and also objectively document the effect on limb vascularity using technetium 99 labeled methylene diphosphonate radionuclide scanning. Materials and Methods: This prospective study was conducted in the Department of Surgery in a Tertiary Care Hospital in North India. A total of 22 patients suffering from chronic peripheral vascular disease unsuitable for corrective arterial surgery underwent omental transposition. Patients were evaluated 1 month after the operation for the change in the clinical parameters and vascularity of the limb using radionuclide scan. Results: Five (22.7%) patients had complete relief, 12 (54.5%) patients had significant relief while 5 (22.7%) patients had no relief in the rest pain. Signs of healing of ulcer were present in 44.4% of patients having ulcers and coldness of the skin was decreased in 18 patients (81.8%). Radionuclide scan demonstrated increased vascularity in the thigh in 78.6% of patients, increased vascularity in calf in 86.4% and increased vascularity in the foot in 44.6%. Conclusions: Omental transposition increases the blood supply in the transposed limb and may be considered as an effective modality for management of chronic limb ischemia in cases where definitive revascularization cannot be carried out.


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