[Irreversible acute muscular ischemia]

Between ischemias healing without sequelae and those requiring amputation, a place whould be reserved for the irreversible muscular ischemias of leg muscles, where the limb can still be preserved by excision of more or less large segments of muscles. These muscular necroses are mainly observed in the ischemias seen during the late stages, but sometimes also at an early stage following massive obstruction of poorly supplied or distal arteries. Treatment of these arterial obstructions with irreversible muscle ischemias is more complex than that of cases seen at an early stage and follows precise rules. It includes in particular muscular excisions most often in the anterior and external parts of the leg, which cause moderate functional sequelae. These excisions limit the risk of the septic or biological complications of revascularization in ischemias seen at a late stage.