Treatment of extensive infected wounds after lower extremity revascularization

A.A. Fokin^1,2, A.V. Makarov^1,2

¹South Ural State Medical University, Chelyabinsk

²Chelyabinsk Regional Clinical Hospital, Chelyabinsk

Among the peripheral artery diseases, the most catastrophic course is characterized by chronic limb-threatening ischemia (CLTI). Successful reconstruction of the main blood flow in patients with CLTI is not a guarantee of a positive treatment result in general. The presence and prevalence of necrosis and the presence of wound infection are the factors determining the possibility of limb preservation. Prolonged hospital stays, the likelihood of getting the hospital flora resistant to many antibiotics, reduced tissue regeneration and numerous interventions are the factors that worsen wound healing in this category of patients. The addition of antibiotic-resistant flora is a significant risk factor for limb loss. The authors present their own experience of patient management with peripheral arterial disease of the lo wer extremities and ulcerative and necrotizing foot lesions. Patients underwent lower limb revascularization, necrectomy, and negative pressure wound therapy. The authors noted the positive effect of silver sulfadiazine use in wound therapy. The balanced patient management, combining active surgical treatment with topical effect on wound healing, allows preventing amputation.

Keywords: peripheral artery diseases, chronic limb-threatening ischemia, antibiotic resistance, revascularization, necrectomy, negative pressure wound therapy, silver sulfadiazine.

For citation: Fokin A.A., Makarov A.V. Treatment of extensive infected wounds after lower extremity revascularization. RMJ. 2021;8:38–40.