Abstract
Negative pressure wound therapy (NPWT) has achieved a certain level of success in the treatment of diabetic foot ulcers. However, critical limb ischemia (CLI) has a complicated pathology, and it is difficult to predict the therapeutic outcome. In 2011, two recommendations were published on the application of NPWT for the treatment of CLI. Recommendation 1: The cautious use of NPWT in chronic limb ischemia when all other modalities have failed may be considered in specialist hands and never as an alternative for revascularization. Recommendation 2: NPWT may be considered as an advanced wound care therapy for lower limb ulceration after successful revascularization. The grades of recommendation were C and D for recommendations 1 and 2, respectively. These grades were lower than the grade of recommendation for NPWT for diabetic ulcers which was published at the same time as the aforementioned. The literature, on which the grades were based, cannot be said to be high-quality studies that examined CLI patients with difficult revascularization, the type of patients encountered by the members of Japanese Society of Limb Salvage and Podiatric Medicine. Treatment strategies for CLI are sought which do not adhere to one treatment method but are flexible and multifaceted.
