SURGICAL MANAGEMENT OF A PATIENT PRESENTING WITH STAGE IV LOWER LIMB ISCHAEMIA AND BEING ON PROGRAMMED HAEMODIALYSIS

Malakhov Yu.S., Averyanov D.A., Marchik V.V., Ivanov A.V.
Vascular Surgery Department of the Central Naval Clinical Hospital,
city of Zheleznodorozhnyi, Moscow Region, Russia

Presented herein is a clinical case report of a male patient suffering from ischaemic gangrene of the foot on the background of an atherosclerotic-genesis multifocal occlusive-and-stenotic lesion of the major arteries of the lower extremities and undergoing programmed haemodialysis for terminal-stage chronic renal insufficiency. The patient was successively subjected to three-stage surgical management, with the first stage consisting of revascularization of the extremity involved by means of «in situ» femoropopliteal aotovenous bypass grafting, the second comprised resection of the calcaneum with the removal of the osteomyelitis focus, and the third one was composed of dermatoautoplasty of the defect of the foot with a split cutaneous flap.

KEY WORDS: chronic arterial insufficiency of the lower extremities, critical ischaemia, chronic renal insufficiency, haemodialysis.

P. 137-139

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