[Trophic foot lesions in patients with chronic bellow knee arterial occlusions]

We operated 51 patients with chronic arterial occlusions of the bellow knee arteries in 2002 and 2003. Sixteen patients had foot lesions, and 8 of them had bones involved (most frequently--the toes). The rest had only skin and soft tissue involvement in the lesions. In most of the cases surgery (toe amputation or debridement) of those lesions was performed as a second stage procedure following the arterial reconstruction. The lesions of the skin and soft tissue are treated with wet to dry antiseptic dressings, and in three cases systemic antibiotic therapy was applied, because of clinical signs for severe infection. In cases of extensive necrotic lesions, they are debrided at the time of arterial surgery, in an effort to limit the risk of systemic sepsis and graft contamination.