The impact of the SARS-CoV-2 pandemic on the management of chronic limb-threatening ischemia and wound care

Authors

Vickie R. Driver, Wound Healing, Limb Preservation and Hyperbaric Centers, Inova Heart and Vascular Institute Inova Health System, Falls Church, Virginia, USA.
Kara S. Couch, Wound Care Services, George Washington University Hospital, Washington, District of Columbia, USA.
Kristen A. Eckert, Strategic Solutions, Inc., Bozeman, Montana, USA.
Gary Gibbons, Center for Wound Healing, South Shore Health, Weymouth, Massachusetts, USA.
Lorena Henderson, PULSE Amputation Prevention Centers, Affiliates, El Paso Cardiology Associates, P.A., El Paso, Texas, USA.
John Lantis, Mount Sinai West Hospital, Icahn School of Medicine, New York, New York, USA.
Eric Lullove, West Boca Center for Wound Healing, Coconut Creek, Florida, USA.
Paul Michael, Palm Beach Heart & Vascular, JFK Wound Management & Limb Preservation Center, Lake Worth, Florida, USA.
Richard F. Neville, Inova Heart and Vascular Institute, Falls Church, Virginia, USA.
Lee C. Ruotsi, Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Saratoga Springs, New York, USA.
Robert J. Snyder, Barry University School of Podiatric Medicine, Miami Shores, Florida, USA.
Fadi Saab, Advanced Cardiac & Vascular Centers for Amputation Prevention, Grand Rapids, Michigan, USA.
Marissa J. Carter, Strategic Solutions, Inc., Bozeman, Montana, USA.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society

Volume

30

Issue

1

DOI

10.1111/wrr.12975

Keywords

COVID-19; SARS-CoV-2; chronic limb-threatening ischemia; severe acute respiratory syndrome coronavirus 2; wound care

Abstract

In the wake of the coronavirus pandemic, the critical limb ischemia (CLI) Global Society aims to develop improved clinical guidance that will inform better care standards to reduce tissue loss and amputations during and following the new SARS-CoV-2 era. This will include developing standards of practice, improve gaps in care, and design improved research protocols to study new chronic limb-threatening ischemia treatment and diagnostic options. Following a round table discussion that identified hypotheses and suppositions the wound care community had during the SARS-CoV-2 pandemic, the CLI Global Society undertook a critical review of literature using PubMed to confirm or rebut these hypotheses, identify knowledge gaps, and analyse the findings in terms of what in wound care has changed due to the pandemic and what wound care providers need to do differently as a result of these changes. Evidence was graded using the Oxford Centre for Evidence-Based Medicine scheme. The majority of hypotheses and related suppositions were confirmed, but there is noticeable heterogeneity, so the experiences reported herein are not universal for wound care providers and centres. Moreover, the effects of the dynamic pandemic vary over time in geographic areas. Wound care will unlikely return to prepandemic practices. Importantly, Levels 2-5 evidence reveals a paradigm shift in wound care towards a hybrid telemedicine and home healthcare model to keep patients at home to minimize the number of in-person visits at clinics and hospitalizations, with the exception of severe cases such as chronic limb-threatening ischemia. The use of telemedicine and home care will likely continue and improve in the postpandemic era.

APA Citation

Driver, Vickie R.; Couch, Kara S.; Eckert, Kristen A.; Gibbons, Gary; Henderson, Lorena; Lantis, John; Lullove, Eric; Michael, Paul; Neville, Richard F.; Ruotsi, Lee C.; Snyder, Robert J.; Saab, Fadi; and Carter, Marissa J., "The impact of the SARS-CoV-2 pandemic on the management of chronic limb-threatening ischemia and wound care" (2022). GW Authored Works. Paper 498.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/498

Department

Surgery