The management of patients with chronic leg wounds requires long-term rest. Thus, advanced dementia and disuse syndrome make walking difficult. The critical limb ischemia that accompanies a chronic leg wound needs revascularization, which significantly prolongs the healing process. Therefore, patients with critical limb ischemia have difficulty in walking and are an increased risk of falling.
　The treatment of critical limb ischemia using total contact cast with negative pressure wound therapy facilitated healing. At the same time, prompt rehabilitation after debridement enabled all patients to maintain their activities of daily living.

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　The aim of this study was to reveal which factor is the most significant for negative-pressure wound therapy to treat diabetic foot ulcers.
　This was a retrospective study on DFU for those treated with NPWT between 2010 and 2011. A total of 23 patients were included. Sixteen cases achieved wound healing, while 7 did not because of poor granulation and infection. We compared these groups in terms of five factors : (1) infection control, (2) glycemic control, (3) blood flow, (4)nutrition, and (5) negative-pressure setting.
　The criteria of indications that were required for NPWT to succeed were WBC < 8000/μl and SPP > 50mmHg. There were weak relationships to albumin, HbA1c, blood sugar average, negative-pressure settings, and treatment period.
　Infection control and blood flow are significant factors for prescribing NPWT for diabetic foot ulcers. WBC is the most sensitive parameter of infection control and the cut-off is 8000/μl. SPP is the most effective parameter of blood flow and the cut-off is 50mmHg. Nutrition, glycemic control, and negative-pressure setting were considered as secondary factors.

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