Vacuum-assisted closure for bilateral severe ischemic foot after revascularization: a case report

Area of Science:

• Vascular Surgery
• Infectious Disease
• Wound Healing

Background:

• Severe ischemic foot presents a significant challenge in wound healing.
• Methicillin-resistant Staphylococcus aureus (MRSA) infections complicate wound management, particularly after amputations.
• Vacuum-assisted closure (VAC) therapy is a recognized method for promoting wound healing.

Observation:

• A 73-year-old male patient with severe ischemic foot underwent digital amputations and bypass surgery.
• The patient developed MRSA infections in his amputation stumps.
• VAC therapy was applied to the infected amputation stumps.

Findings:

• VAC therapy markedly improved wound healing in the patient's amputation stumps, even with MRSA infection.
• Histopathologic examination of the healed stumps revealed increased granulation tissue with abundant microvessels.
• While VAC therapy was effective for stump healing, the patient also required further bypass surgery for a separate gangrenous toe.

Implications:

• VAC therapy demonstrates efficacy in managing complex, infected amputation stumps in ischemic limbs.
• The findings suggest VAC therapy can promote robust granulation and neovascularization in challenging wound environments.
• This case highlights the potential of VAC therapy as an adjunct treatment in vascular surgery patients with infected wounds.