{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:36:55Z","timestamp":1783496215728,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Thromboangiitis obliterans (TAO) is a rare, tobacco\u2010associated vasculitis that primarily affects the distal extremities of young males. In advanced stages, it often leads to chronic limb ischemia with ischemic ulceration, culminating in amputation. Data on risk factors for reamputation in this population remain limited. This study aimed to identify clinical, radiological and microbiological predictors of reamputation in patients with TAO\u2010related foot ulcers undergoing amputation. A retrospective cohort study was conducted on 25 patients (31 limbs) with Fontaine stage IV TAO ulcers who underwent lower extremity amputation between January 2021 and December 2024. Patients were stratified into two groups based on whether they underwent repeat amputation (Group 1) or a single procedure (Group 2). Preoperative magnetic resonance imaging, intraoperative tissue cultures and laboratory data were evaluated. Smoking status, hospitalisation metrics and adjunctive therapies were recorded. Statistical analysis included Mann\u2013Whitney U, Fisher's exact test, ROC curve analysis and multivariate logistic regression. Seventeen limbs required reamputation. Persistent smoking was observed in 100% of Group 1 compared with 58.4% of Group 2 (\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.015). Positive intraoperative cultures were significantly more frequent in Group 1 (64.7% vs. 21.4%;\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.029), with all multidrug\u2010resistant organisms confined to this group. Length of hospital stay was significantly longer in Group 1 (25.2\u2009\u00b1\u20096.4 vs. 15.8\u2009\u00b1\u20095.3\u2009days;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). ROC analysis identified &gt;\u200919\u2009days of hospitalisation as a threshold for reamputation risk (AUC\u2009=\u20090.781;\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.018). Multivariate analysis identified three independent predictors of reamputation: persistent smoking (OR: 5.2, 95% CI: 1.2\u201322.8;\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.015), positive intraoperative culture (OR: 4.7, 95% CI: 1.1\u201320.1;\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.041), and hospitalisation longer than 19\u2009days (OR: 6.5, 95% CI: 1.4\u201329.4;\n                    <jats:italic>p<\/jats:italic>\n                    =\u20090.018). Reamputation in advanced\u2010stage TAO is strongly associated with modifiable factors, particularly ongoing tobacco use, Gram\u2010negative infection and prolonged hospital stay. Early identification and targeted intervention addressing these variables may improve limb preservation outcomes in this high\u2010risk population.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70853","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:46:17Z","timestamp":1771465577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Reamputation in Patients With Advanced\u2010Stage Thromboangiitis Obliterans Ulcers: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3893-797X","authenticated-orcid":false,"given":"Yi\u011fit","family":"\u00d6nalo\u011flu","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3818-7606","authenticated-orcid":false,"given":"\u00d6mer Faruk","family":"G\u00fcm\u00fc\u015f","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4548-5857","authenticated-orcid":false,"given":"Bekir","family":"Karak\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5272-1542","authenticated-orcid":false,"given":"Ali Volkan","family":"\u00d6zl\u00fck","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1565-9620","authenticated-orcid":false,"given":"Emin Can","family":"Balc\u0131","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Bagcilar Training and Research Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7734-6438","authenticated-orcid":false,"given":"Mehmet Ali","family":"Talma\u00e7","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-4955","authenticated-orcid":false,"given":"Melih","family":"Civan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2016.03.028"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010677"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.08.2011.4621"},{"issue":"2","key":"e_1_2_13_5_1","first-page":"153","article-title":"The Association of HLA\u2010A, B and DRB1 With Buerger's Disease","volume":"8","author":"Shapouri\u2010Moghaddam A.","year":"2019","journal-title":"Reports of Biochemistry and Molecular 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Smoking and Peripheral Vascular Disease Are Associated With Increasing Risk of ESKAPE Pathogen Infection in Diabetic Foot Ulcers","volume":"15","author":"Li T.","year":"2022","journal-title":"Diabetes, Metabolic Syndrome and Obesity: Targets and 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