A Case of an Ischemic Regio Sacralis Ulcer Due to Internal Iliac Artery Stenosis Resembling Clinical Presentation of Deep Tissue Injury

Abstract

We present a 50-year-old male with chronic limb-threatening ischemia, type 2 diabetes, end-stage renal failure, and ischemic heart disease. He developed an ulcer with redness and partial darkening in the sacral region 1 day after distal bypass grafting for right lower extremity. There was clinical suspicion of Deep Tissue Injury (DTI), tissue oxygen saturation (StO₂) showed 12–14% around the ulcer, suggesting ischemic ulcer. Angiography showed a proximal segment of right Internal Iliac Artery with 75% stenosis and severe calcification. A stent was placed after balloon dilation, resulting in StO₂ of 54–80% the following day. The wound was completely healed on day 50 after revascularization.