Author(s): Rajendra Prasad Das1, Niranjan Sahoo2, Sushanta Kumar Das3, Paresh Kumar Gouda4
Twelve cases of Buerger’s disease with post lumbar sympathectomy were subjected to omentoplasty for the purpose of neovascularisation of distal part to alleviate rest pain and healing of ulcer after resurfacing with SSG. All the cases didn’t improve after lumbar sympathectomy with rest pain and ulceration of distal part were subjected to omentoplasty to improve the rest pain and healing of ulcer. The mean period of surveillance was 2 years 4 months. All the 12 cases were male with habitual tobacco smokers for 15 to 20 years who developed impending gangrene of toes with ulceration to established gangrene of toes with ulceration. Out of 12 cases 7 had gangrene of toes with non-healing ulcer and rest pain and 5 had impending gangrene of the toes with ulceration. The results of post omentoplasty showed significant gradual improvement in rest pain and healing status of ulcer, thereby negating the role of amputation with salvage of limb. The principle behind omentoplasty is initiation of the process of neovascularisation from the vascularised omental pedicle. The surgical skill plateau of learning curve can be reached within a shorter duration, thereby making it a choice of surgery in cases with poor result following lumbar sympathectomy in Buerger’s disease as a process of salvaging the limb.