Uso de terapia de presión negativa en una paciente con isquemia crónica no revascularizable.

Patient who presented an injury to the right lower limb (Achilles region) with tendon exposure and sloughs, secondary to decubitus after prolonged immobilization. Femoropopliteal occlusion was evidenced with anklearm index of 0.36. Given the complexity of the lesions, the non-revascularization option and the high risk of the patient, a conservative approach was decided and a surgical debridement of the lesion was performed. After enzymatic debridement using topical urokinase (100,000 IU / 100ml NaCl 0.9%), negative pressure therapy was started, which allowed the wound to heal in 14 weeks. Negative pressure therapy can be particularly useful as a treatment of arterial ulcers in patients with chronic non-revascularizable ischemia.