Abstract
Critically ischemic limbs with extensive tissue loss may be candidates for major amputation. However, aggressive therapy, which was bypass surgery with free flap transfer, can reduce the need for major amputation. We report two cases of ischemic limb with tissue loss, which were treated successfully with bypass surgery, vacuum-assisted closure and free flap transfer. Case 1: A patient with tissue loss around left heel, firstly underwent bypass surgery and debridement of the heel. The heel wound was treated with vacuum-assisted closure therapy, accelerating granulation. After that, free flap transfer was performed with covering split-thickness skin graft. Case 2: A patient with right plantar tissue loss first underwent bypass surgery and debridement. The wound plantar was treated with vacuum-assisted closure therapy, accelerating granulation. After that, free flap transfer was performed with covering split-thickness skin graft. A multidisciplinary approach for ischemic limbs with tissue loss can provide excellent results, and this procedure should be considered in patients with extensive tissue loss before amputation is performed.
