Circumferential constriction ischaemic syndrome (CCIS): A potentially reversible ischaemic condition of lower limb

Circumferential constriction in limb will lead to distal limb ischaemia. This is a potentially reversible condition but it has a drastic consequence if undiagnosed. We described a patient with underlying diabetes mellitus presented with persistent lower limb linear circumferential ulcer and developi...

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Bibliographic Details
Main Authors: Chris Yuk Kwan Tang, Ng Ka Ho, Nicola Ho, Yuki Kwok
Format: Article
Language:English
Published: SAGE Publishing 2020-06-01
Series:Journal of Orthopaedics, Trauma and Rehabilitation
Online Access:https://doi.org/10.1177/2210491719890881
Description
Summary:Circumferential constriction in limb will lead to distal limb ischaemia. This is a potentially reversible condition but it has a drastic consequence if undiagnosed. We described a patient with underlying diabetes mellitus presented with persistent lower limb linear circumferential ulcer and developing subacute limb ischaemia distal to the ulcer. During further wound dressing, a rubber band was detected in the wound. Surgical exploration removed the rubber band and its circumferential constriction effect. As a result, the ulcer healed uneventfully and the distal limb perfusion improved clinically. A scoring index consisted of contributing risk factors was proposed to facilitate the diagnosis. A flow chart was proposed to serve as a treatment protocol to ensure logical and comprehensive management. We hope the proposal of the new term and flow chart can help improve the threshold of recognition and for salvage of potentially devastating limb ischaemia.
ISSN:2210-4917
2210-4925