Chronic limb-threatening ischemia (CLTI) is associated with a short-term risk of limb loss. Multidisciplinary teams are often involved in CLTI treatment; however, in Asian countries, multidisciplinary teams that include podiatrists specializing in foot
wounds and vascular surgeons who can perform distal bypass surgery are lacking. We investigated predictive factors for
limb salvage and
foot ulcer recurrence in patients with CLTI treated by a Japanese single-center intensive multidisciplinary team over 6 years. We retrospectively investigated 84 patients with CLTI and
foot ulcers who had undergone revascularization and
wound treatment between October 2013 and December 2019. Following postrevascularization treatment, including undertaking minor
amputations, the healing rate was 77.8%, and the average wound healing time was 75 ± 68 days. To achieve adequate blood supply, 17.7% of patients were treated using a combination of endovascular revascularization and bypass surgeries. Thirty-three (44%) patients had
wound recurrence and there was
wound recurrence within 6 months in 58.9% of these patients. Multivariate logistic regression analysis showed that postrevascularization skin perfusion pressure was significantly associated with wound healing (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.033-1.243, P = .0078).
Diabetes mellitus (OR 9.72, 95% CI 1.855-50.937, P = .0071), and
heart disease (OR 3.51, 95% CI 1.052-11.693, P = .0411) were significantly associated with
wound recurrence (P < .05). Treatment within a single-center intensive multidisciplinary team resulted in good patient outcomes. Our study indicates that the revascularization endpoint of CLTI treatment should be marked by attainment of adequate blood supply and wound healing. The timing of revascularization and
debridement is of utmost importance for the successful treatment of CLTI
wounds.