MANAGEMENT OF NECROTIC LESIONS IN CHRONIC LIMB ISCHEMIA

C.D. Sandu1, Corina Constantin1, Laura Răducu1,2, Oriana Moraru 3, C.A. Vișan 1

1Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2Plastics and Reconstructive Microsurgery Department, “Prof. Dr. Agripa Ionescu” Emergency Clinical Hospital, Bucharest, Romania
3Vascular Surgery Department, “Prof. Dr. Agripa Ionescu” Emergency Clinical Hospital, Bucharest, Romania


Corresponding author: Constantin Dragoș Sandu
Phone no. 0040 720560567
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Peripheral vascular disease commonly affects the arteries supplying the leg and is mostly caused by atherosclerosis. Restriction of blood flow due to arterial stenosis or occlusion often leads patients to complain of muscle pain on walking (intermittent claudication). Any further reduction in blood flow causes ischemic pain at rest, affecting by consequence the extremity. Ulceration and gangrene may then supervene and can result in loss of the limb if not treated.We present the case of a 55 year old male, C.I., with tissue necrosis of the right calf, aching pain at rest in the distal foot and disabling claudication (stage IV Fontaine PAOD).The patient’s history reveals that he is a former smoker undergoing anticoagulation and vasodilation treatment. He also suffered severe spinal cord injury leading to paraplegia in 2008, a laryngeal neoplasm surgery in 2013 and a PTA with stent placement in the proximal right CIA.

Keywords: claudication, ulceration, gangrene, split-thickness skin graft, femoropopliteal bypass

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