A Case Report of Wound Care Including Herbal Medicine and Acupuncture for a Chronic Ischemic Foot Ulcer Following Acute Lower-Extremity Arterial Occlusion

Introduction: Chronic ischemic foot ulcers may persist after revascularization and require prolonged wound care.Case presentation: A 52-year-old man developed right hemiplegia after cerebral infarction and subsequently underwent thrombectomy and percutaneous transluminal angioplasty for acute total occlusion of the right lower-extremity artery. Despite revascularization, a chronic ischemic foot ulcer persisted for more than 1 year. The patient was treated with <i>Gami-sipjeondaebo-tang</i>, acupuncture, and twice-daily moist dressings. During the first admission, the ulcer size decreased from 2.0×2.0 cm to 0.5×1.2 cm, and the Wound Bed Score (WBS) improved from 10 to 14. After a 1-month postdischarge period without follow-up, the ulcer worsened and a new ulcer developed. During the second admission, the new ulcer healed completely, and the preexisting ulcer improved from 2.6×3.0 cm to 0.7×1.1 cm, with the WBS improving from 9 to 15.Conclusion: This case suggests that integrated conservative treatment, including Gami-sipjeondaebo-tang, acupuncture, and wet dressing, may be considered an adjunctive treatment option for chronic ischemic foot ulcers persisting after revascularization.