King Fahad Medical City, Riyadh, Saudi Arabia.
Libyan J Med. 2011 Apr 20;6. doi: 10.3402/ljm.v6i0.6415.
Complications of pedal wounds closed primarily after release of neglected cases of club foot are well known in literature. We treated a 12-year-old boy presenting with widespread necrosis involving medial aspect of foot after release of neglected talipes equinovarus. Such widespread necrosis is even known to end up in amputations and permanent disabilities. In our case, the foot was successfully salvaged by resorting to dedicated wound care, multiple debridements, use of topical negative pressure (vacuum-assisted closure - VAC), and skin grafting. Various means to prevent such adverse events are also presented. The aim of publishing this case is to stress the need to:Take proper measures preoperatively in neglected club feet to decrease the impact of deformity.To be aware of various different flaps and methods of closure as mentioned in literature and to reaffirm the fact that primary closures done under tension are bound to fail and end up in disasters.To be patient and use the modern concepts of wound management like topical negative pressure if such unfortunate complications do occur and thereby attempt to salvage the feet.
文献中已知，在忽视性马蹄内翻足病例释放后，初次缝合的足部伤口会出现多种并发症。我们治疗了一名 12 岁男孩，他在忽视性马蹄内翻足释放后出现广泛的足部内侧坏死。这种广泛的坏死甚至可能导致截肢和永久性残疾。在我们的病例中，通过专门的伤口护理、多次清创、使用负压（真空辅助闭合-VAC）和植皮，成功挽救了足部。还提出了各种预防此类不良事件的方法。发表此病例的目的是强调需要：
在忽视性马蹄内翻足术前采取适当措施，减轻畸形的影响。
了解文献中提到的各种不同皮瓣和闭合方法，并再次确认在张力下进行的初次缝合必然会失败并导致灾难。
如果出现这种不幸的并发症，要有耐心并使用现代伤口管理概念，如负压治疗，从而尝试挽救足部。
