{"id":"https://openalex.org/W7203663002","doi":"https://doi.org/10.67702/zfzc7122","title":"Staged Limb Salvage in Complex Lower-Extremity Wounds: A Case Series Demonstrating Real-World Application of Advanced Wound Care Strategies","display_name":"Staged Limb Salvage in Complex Lower-Extremity Wounds: A Case Series Demonstrating Real-World Application of Advanced Wound Care Strategies","publication_year":2026,"publication_date":"2026-08-14","ids":{"openalex":"https://openalex.org/W7203663002","doi":"https://doi.org/10.67702/zfzc7122"},"language":"en","primary_location":{"id":"doi:10.67702/zfzc7122","doi":"https://doi.org/10.67702/zfzc7122","is_oa":true,"landing_page_url":"https://doi.org/10.67702/zfzc7122","pdf_url":"https://www.cwcmr.com/hubfs/final_SFrade_Limb%20salvage_.pdf?hsLang=en","source":{"id":"https://openalex.org/S2738241810","display_name":"Chronic Wound Care Management and Research","issn_l":"2324-481X","issn":["2324-481X"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chronic Wound Care Management and Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.cwcmr.com/hubfs/final_SFrade_Limb%20salvage_.pdf?hsLang=en","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5134383936","display_name":"Neal Patel","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Neal Patel","raw_affiliation_strings":["Indy Wound Center for Limb Preservation & Reconstruction, Indianapolis, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Indy Wound Center for Limb Preservation & Reconstruction, Indianapolis, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147428408","display_name":"Thomas Zumbaugh","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Thomas Zumbaugh","raw_affiliation_strings":["Indy Wound Center for Limb Preservation & Reconstruction, Indianapolis, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Indy Wound Center for Limb Preservation & Reconstruction, Indianapolis, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5129511546","display_name":"Sasha Frade","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405286448","display_name":"Open Wound Research (United States)","ror":"https://ror.org/025bc4w45","country_code":"US","type":"company","lineage":["https://openalex.org/I4405286448"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sasha Frade","raw_affiliation_strings":["Open Wound Research, Washington, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Open Wound Research, Washington, USA","institution_ids":["https://openalex.org/I4405286448"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5099183896","display_name":"Zwelithini Tunyiswa","orcid":"https://orcid.org/0009-0008-6100-0828","observed_orcids":["https://orcid.org/0009-0008-6100-0828"]},"institutions":[{"id":"https://openalex.org/I4405286448","display_name":"Open Wound Research (United States)","ror":"https://ror.org/025bc4w45","country_code":"US","type":"company","lineage":["https://openalex.org/I4405286448"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Zwelithini Tunyiswa","raw_affiliation_strings":["Open Wound Research, Washington, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Open Wound Research, Washington, USA","institution_ids":["https://openalex.org/I4405286448"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":1806,"currency":"USD","value_usd":1806},"apc_paid":{"value":1806,"currency":"USD","value_usd":1806},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"1","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10771","display_name":"Wound Healing and Treatments","score":0.9340999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10771","display_name":"Wound Healing and Treatments","score":0.9340999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11227","display_name":"Diabetic Foot Ulcer Assessment and Management","score":0.03849999979138374,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11422","display_name":"Burn Injury Management and Outcomes","score":0.0031999999191612005,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/negative-pressure-wound-therapy","display_name":"negative pressure wound therapy","score":0.8420000076293945},{"id":"https://openalex.org/keywords/dermal-regeneration-template","display_name":"dermal regeneration template","score":0.8569999933242798},{"id":"https://openalex.org/keywords/surgical-debridement","display_name":"surgical debridement","score":0.9929999709129333},{"id":"https://openalex.org/keywords/wound-bed-preparation","display_name":"wound bed preparation","score":0.8389999866485596},{"id":"https://openalex.org/keywords/osteomyelitis","display_name":"osteomyelitis","score":0.8059999942779541},{"id":"https://openalex.org/keywords/exposed-tendons","display_name":"exposed tendons","score":0.6700000166893005},{"id":"https://openalex.org/keywords/traumatic-wounds","display_name":"traumatic wounds","score":0.8569999933242798},{"id":"https://openalex.org/keywords/wound-closure","display_name":"wound closure","score":0.6970000267028809},{"id":"https://openalex.org/keywords/graft-loss","display_name":"graft loss","score":0.6610000133514404},{"id":"https://openalex.org/keywords/multidisciplinary-wound-care","display_name":"multidisciplinary wound care","score":0.7519999742507935}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8651999831199646},{"id":"https://openalex.org/C2993807428","wikidata":"https://www.wikidata.org/wiki/Q25324087","display_name":"Wound care","level":2,"score":0.7656999826431274},{"id":"https://openalex.org/C2779232120","wikidata":"https://www.wikidata.org/wiki/Q1511599","display_name":"Negative-pressure wound therapy","level":3,"score":0.7276999950408936},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.6380000114440918},{"id":"https://openalex.org/C2993873987","wikidata":"https://www.wikidata.org/wiki/Q184753","display_name":"Wound closure","level":3,"score":0.6111999750137329},{"id":"https://openalex.org/C2776055305","wikidata":"https://www.wikidata.org/wiki/Q1543255","display_name":"Granulation tissue","level":3,"score":0.5177000164985657},{"id":"https://openalex.org/C2780269544","wikidata":"https://www.wikidata.org/wiki/Q1509074","display_name":"Wound healing","level":2,"score":0.4894999861717224},{"id":"https://openalex.org/C2780775027","wikidata":"https://www.wikidata.org/wiki/Q17141389","display_name":"Salvage therapy","level":3,"score":0.39750000834465027},{"id":"https://openalex.org/C2777750529","wikidata":"https://www.wikidata.org/wiki/Q1591440","display_name":"Skin grafting","level":2,"score":0.3569999933242798},{"id":"https://openalex.org/C2780913535","wikidata":"https://www.wikidata.org/wiki/Q2140674","display_name":"Gunshot wound","level":2,"score":0.3303000032901764},{"id":"https://openalex.org/C136948725","wikidata":"https://www.wikidata.org/wiki/Q1458306","display_name":"Soft tissue","level":2,"score":0.32510000467300415},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3215000033378601},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.29010000824928284},{"id":"https://openalex.org/C3020304732","wikidata":"https://www.wikidata.org/wiki/Q1671866","display_name":"Surgical wound","level":2,"score":0.28949999809265137},{"id":"https://openalex.org/C3020442560","wikidata":"https://www.wikidata.org/wiki/Q4971815","display_name":"Broad spectrum","level":2,"score":0.28130000829696655},{"id":"https://openalex.org/C2993914291","wikidata":"https://www.wikidata.org/wiki/Q166231","display_name":"Wound infection","level":2,"score":0.28110000491142273},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.2766000032424927},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.27480000257492065},{"id":"https://openalex.org/C171056886","wikidata":"https://www.wikidata.org/wiki/Q193119","display_name":"Regeneration (biology)","level":2,"score":0.27149999141693115},{"id":"https://openalex.org/C2781051411","wikidata":"https://www.wikidata.org/wiki/Q2078852","display_name":"Chronic wound","level":3,"score":0.2547999918460846}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.67702/zfzc7122","doi":"https://doi.org/10.67702/zfzc7122","is_oa":true,"landing_page_url":"https://doi.org/10.67702/zfzc7122","pdf_url":"https://www.cwcmr.com/hubfs/final_SFrade_Limb%20salvage_.pdf?hsLang=en","source":{"id":"https://openalex.org/S2738241810","display_name":"Chronic Wound Care Management and Research","issn_l":"2324-481X","issn":["2324-481X"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chronic Wound Care Management and Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.67702/zfzc7122","doi":"https://doi.org/10.67702/zfzc7122","is_oa":true,"landing_page_url":"https://doi.org/10.67702/zfzc7122","pdf_url":"https://www.cwcmr.com/hubfs/final_SFrade_Limb%20salvage_.pdf?hsLang=en","source":{"id":"https://openalex.org/S2738241810","display_name":"Chronic Wound Care Management and Research","issn_l":"2324-481X","issn":["2324-481X"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chronic Wound Care Management and Research","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9940000176429749,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203663002.pdf","grobid_xml":"https://content.openalex.org/works/W7203663002.grobid-xml"},"referenced_works_count":13,"referenced_works":["https://openalex.org/W1537657195","https://openalex.org/W1911377552","https://openalex.org/W1984669542","https://openalex.org/W1991974656","https://openalex.org/W2049204288","https://openalex.org/W2049920231","https://openalex.org/W2120033284","https://openalex.org/W2131226296","https://openalex.org/W2402202411","https://openalex.org/W3139358517","https://openalex.org/W4234300503","https://openalex.org/W4312188510","https://openalex.org/W4382918816"],"related_works":["https://openalex.org/W1536338315","https://openalex.org/W3027839011","https://openalex.org/W3048956825","https://openalex.org/W6967534749","https://openalex.org/W3043513519","https://openalex.org/W2313967157","https://openalex.org/W7147489813","https://openalex.org/W2405844848","https://openalex.org/W2974746168","https://openalex.org/W2024420989"],"abstract_inverted_index":{"Background:":[0],"Complex":[1],"lower-extremity":[2,62],"wounds":[3,63,138],"are":[4,34,266],"associated":[5],"with":[6,16,60,149,167,194],"substantial":[7],"morbidity":[8],"and":[9,19,29,92,116,154,251,257],"risk":[10],"of":[11,103,213,223,232,241],"amputation,":[12,202],"particularly":[13],"in":[14,37,65,163,182,254,261,271],"patients":[15,59],"significant":[17],"comorbidities":[18],"advanced":[20,30],"disease.":[21],"Although":[22],"staged":[23,75,225,252],"limb":[24,76,226,259],"salvage":[25,77,179,227,260],"approaches":[26],"incorporating":[27,246],"surgical":[28,81],"wound":[31,50,69,85,105,120,145,159,196,199,234,248],"care":[32,70],"strategies":[33,245],"increasingly":[35],"used":[36],"clinical":[38],"practice,":[39],"there":[40],"is":[41],"currently":[42],"limited":[43],"evidence":[44],"describing":[45],"their":[46],"application":[47,222],"across":[48,229],"diverse":[49],"types.":[51],"Methods:":[52],"This":[53],"descriptive":[54],"case":[55],"series":[56],"reports":[57],"four":[58,165],"complex":[61,233],"managed":[64],"a":[66,73,101,224,230],"specialized":[67],"outpatient":[68],"practice":[71],"using":[72],"structured":[74],"approach.":[78],"Management":[79],"included":[80],"debridement,":[82,148,247],"negative":[83],"pressure":[84],"therapy":[86],"(NPWT),":[87],"dermal":[88],"regeneration":[89],"template":[90],"application,":[91],"adjunctive":[93],"therapies":[94],"as":[95],"clinically":[96],"indicated.":[97],"The":[98,236],"cases":[99,218],"represent":[100],"spectrum":[102],"high-risk":[104,262],"presentations,":[106],"including":[107],"exposed":[108],"tendon,":[109],"deep":[110],"soft":[111],"tissue":[112,152],"defects,":[113],"traumatic":[114],"wounds,":[115],"osteomyelitis.":[117],"Results:":[118],"Initial":[119],"dimensions":[121],"ranged":[122],"from":[123,141,173],"7.4":[124],"\u00d7":[125,127,132,134],"4.0":[126],"1.0":[128],"cm":[129],"to":[130,143,169,175,268],"12.0":[131],"6.5":[133],"2.0":[135],"cm.":[136],"All":[137],"demonstrated":[139],"progression":[140],"non-viable":[142],"viable":[144],"beds":[146],"following":[147],"subsequent":[150,201],"granulation":[151],"formation":[153],"advancement":[155],"toward":[156],"closure.":[157],"Complete":[158],"closure":[160,171],"was":[161,180,192],"achieved":[162,181],"all":[164,183],"patients,":[166],"time":[168],"confirmed":[170],"ranging":[172],"4":[174],"12":[176],"months.":[177],"Limb":[178],"cases.":[184],"One":[185],"patient":[186,273],"experienced":[187],"partial":[188],"graft":[189],"loss,":[190],"which":[191],"resolved":[193],"continued":[195],"care.":[197],"No":[198],"recurrence,":[200],"rehospitalization,":[203],"or":[204],"major":[205],"treatment-related":[206],"complications":[207],"were":[208],"documented":[209],"during":[210],"1\u20132":[211],"months":[212],"post-closure":[214],"follow-up.":[215],"Conclusions:":[216],"These":[217],"illustrate":[219],"the":[220,239],"real-world":[221],"approach":[228],"range":[231],"etiologies.":[235],"findings":[237],"support":[238],"role":[240],"structured,":[242],"multidisciplinary":[243],"management":[244],"bed":[249],"preparation,":[250],"reconstruction":[253],"promoting":[255],"healing":[256],"achieving":[258],"patients.":[263],"Further":[264],"studies":[265],"warranted":[267],"evaluate":[269],"outcomes":[270],"larger":[272],"populations.":[274]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-08-19T00:00:00"}
