en تخصصي Special مقالات اصيل Original Article <span style="font-size:10.5pt"><span style="line-height:200%"><span style="text-autospace:none"><span serif="" style="font-family:游明朝,"><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Revascularization surgery was first considered for the treatment of ulcers in patients with critical limb ischemia (CLI)</span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">.</span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> However, it may not be indicated for patients with severe infections or peripheral vascular occlusions. Although blood purification therapy is adjuvant therapy for such patients, it is not yet widely used due to insurance coverage. We report a case of a refractory heel ulcer with moderate osteomyelitis and cellulitis that was not amenable to revascularization. Treatment with the adsorptive blood purifier rheocarna^&reg; (Kaneka Corporation; Osaka, Japan) resulted in complete epithelialization of the ulcer and control of inflammation. Although this case required careful follow-up, we believe rheocarna might be a promising treatment option for patients </span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">with CLI who do not respond to revascularization. </span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Rheocarna</span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> could improve peripheral blood flow and control inflammation by improving antibiotic drug delivery.</span></span></span><span style="font-size:12.0pt"><span style="line-height:200%"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></span></span><br> &nbsp; Arteriosclerosis obliterans, Blood purification therapy, Critical limb ischemia, Osteomyelitis 106 110 http://wjps.ir/browse.php?a_code=A-10-891-1&slc_lang=en&sid=1 Makoto Shimabukuro 100319475328460015063 100319475328460015063 No Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tochigi, Japan Naohiro Ishii ishinao0916@gmail.com 100319475328460015064 100319475328460015064 Yes Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan Takanori Ko 100319475328460015065 100319475328460015065 No Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tochigi, Japan Kazuo Kishi 100319475328460015066 100319475328460015066 No Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan