[Bier's occlusion. An unjustly neglected therapeutic possibility in resistant tissue defects of the extremities]

The retrograde intravenous pressure infusion into an arterially occluded segment of an extremity (Bier's technique) is the most effective method to achieve maximal tissue concentrations of a drug. This was proven by nuclear medical examinations. By application of contrast-medium it was shown that the injected fluid penetrates in a retrograde direction into the foot inspite of primarily intact valves. A second important mechanism of action is the haemodynamic consequence of an arterial occlusion which is characterized not only by an immediate reactive hyperaemic response but also by a delayed increase of blood flow after several days. Favourable clinical results were obtained with antibiotics in infected gangrene of the feet or in necrotizing erysipelas and with urokinase in resistant leg ulcers.