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Complications may include an infection or tissue death, which may require amputation; coronary artery disease; or stroke. [4] Up to 50% of people with PAD do not have symptoms. [2] The greatest risk factor for PAD is cigarette smoking. [4] Other risk factors include diabetes, high blood pressure, kidney problems, and high blood cholesterol.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
Hand transplantation, or simply a hand transplant, is a surgical procedure to transplant a hand from one human to another. The donor hand, usually from a brain-dead donor, is transplanted to a recipient amputee. Most hand transplants to date have been performed on below-elbow amputees, although above-elbow transplants are gaining popularity.
Foot of an 80-year old individual with type 2 diabetes and heart failure. The second toe has a large ischaemic ulcer. The first toe has a small one. The prevalence of arterial insufficiency ulcers among people with Diabetes is high due to decreased blood flow caused by the thinning of arteries and the lack of sensation due to diabetic neuropathy.
8 years (2 years of core surgery + 6 years of vascular surgery) United States American Board of Surgery American Osteopathic Board of Surgery: Society for Vascular Surgery American College of Surgeons: 5 years (4 via 5-year integrated Vascular Surgery Residency). 7 if completing as a 2-year fellowship following general surgery [46]
An ABPI between and including 0.90 and 1.29 considered normal (free from significant PAD), while a lesser than 0.9 indicates arterial disease. [14] An ABPI value of 1.3 or greater is also considered abnormal, and suggests calcification of the walls of the arteries and incompressible vessels, reflecting severe peripheral vascular disease .
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Hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (commonly from the tip of the hand to the shoulder) [1] including injury and infection. [2] Hand surgery may be practiced by post graduates of orthopedic surgery and plastic surgery and MCh Hand surgery. [1]