Vacuum-assisted closure therapy for a complicated, open, above-the-knee amputation wound.

Negative-pressure wound therapy (NPWT) with a vacuum-assisted closure system has been successfully used in the management of various wounds on the trunk and distal extremities, including diabetic foot ulcers. However, reported successful NPWT cases have involved distal wounds that were below the knee. The authors report a case of an elderly diabetic patient with recalcitrant wounds in his left lower extremity from an above-the-knee amputation. The patient had undergone 27 surgical débridement or revision procedures over the course of 3 months. On entering rehabilitation, the patient had a full-thickness wound in his residual limb that measured 9 × 8 cm. The patient received NPWT with a vacuum-assisted closure system, which resulted in a fully healed residual limb. After 120 days, the patient was ready to begin prosthetic restoration.