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Staged Limb Salvage in Complex Lower-Extremity Wounds: A Case Series Demonstrating Real-World Application of Advanced Wound Care Strategies

Year: 2026

Type: article

Abstract: Background: Complex lower-extremity wounds are associated with substantial morbidity and risk of amputation, particularly in patients with significant comorbidities and advanced disease. Although staged limb salvage approaches incorporating surgical and advanced wound care strategies are increasingly used in clinical practice, there is currently limited evidence describing their application across diverse wound types. Methods: This descriptive case series reports four patients with complex lower-extremity wounds managed in a specialized outpatient wound care practice using a structured staged limb salvage approach. Management included surgical debridement, negative pressure wound therapy (NPWT), dermal regeneration template application, and adjunctive therapies as clinically indicated. The cases represent a spectrum of high-risk wound presentations, including exposed tendon, deep soft tissue defects, traumatic wounds, and osteomyelitis. Results: Initial wound dimensions ranged from 7.4 × 4.0 × 1.0 cm to 12.0 × 6.5 × 2.0 cm. All wounds demonstrated progression from non-viable to viable wound beds following debridement, with subsequent granulation tissue formation and advancement toward closure. Complete wound closure was achieved in all four patients, with time to confirmed closure ranging from 4 to 12 months. Limb salvage was achieved in all cases. One patient experienced partial graft loss, which was resolved with continued wound care. No wound recurrence, subsequent amputation, rehospitalization, or major treatment-related complications were documented during 1–2 months of post-closure follow-up. Conclusions: These cases illustrate the real-world application of a staged limb salvage approach across a range of complex wound etiologies. The findings support the role of structured, multidisciplinary management strategies incorporating debridement, wound bed preparation, and staged reconstruction in promoting healing and achieving limb salvage in high-risk patients. Further studies are warranted to evaluate outcomes in larger patient populations.

Source: Chronic Wound Care Management and Research

DOI: 10.67702/zfzc7122

Authors: Neal Patel, Thomas Zumbaugh, Sasha Frade, Zwelithini Tunyiswa

Institution: Open Wound Research (United States)

Language: English

Topic: Wound Healing and Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,806