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case_images: The condition of the patient's lower limb before the first debridement.
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case_images: Over time, the bruise grew into a flesh-colored, slightly tender, protuberant mass measuring 20 cm x 35 cm with cyanotic vesicles (Figure 1).
case_images: The lesion of the right lower leg after two debridements at admission. Multiple ulcers and a superficial scar were visible on the dorsal area of the right calf.
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case_images: There were also blisters, ulcerations, continuous seeping of lymph-like clear liquid, and some bleeding (Figure 2).
case_images: Surgery on the first day after admission. (A) The clearly necrotic tissue was entirely removed. Arrows indicate the sural nerve. (B) Two vacuum sealing drainage devices were installed after the debridement.
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case_images: The 18 cm x 28 cm incision was then cleaned (Figure 3A), two vacuum sealing drainage (VSD) sponges were placed on the wound, and two semipermeable membranes were used to seal the wound before applying negative pressure (Figure 3B).
case_images: Skin grafting two weeks after debridement. (A) The necrotic tissue was completely removed, with a promising amount of fresh granulation tissue covering the wound before the skin graft operation. (B) The split-thickness skin graft was sutured to the wound.
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case_images: Two weeks after admission, the patient received an 18 cm x 28 cm split-thickness skin graft (STSG), harvested from the right thigh, to cover the wound on the right calf (Figure 4). 
case_images: Pathological examination showing ectatic vascular spaces (white arrow) lined by flattened, cytologically bland endothelial cells (black arrow) dissecting through subcutaneous fat (Hematoxylin-eosin stain; original magnifications: B, x 4).
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case_images: Microscopic analysis revealed irregular, dilated vascular spaces lined with a single layer of flat endothelial cells, which showed no signs of nuclear atypia or mitotic activity (Figure 5).
case_images: The narrow vascular spaces separated by reticular dermal collagen bundles in the dermis. (Hematoxylin-eosin stain; original magnifications: B, x 4).
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case_images: The narrow vascular spaces within the dermis were separated by reticular dermal collagen bundles (Figure 6).