What Researchers Did
Researchers reported on a surgical approach to successfully treat a large, painful leg ulcer in a patient with systemic sclerosis, after other conservative treatments, including hyperbaric oxygen, had failed.
What They Found
Initial treatments, including systemic antibiotics, nifedipine, intravenous iloprost, intravenous penicillin G, and hyperbaric oxygen, failed to heal the ulcer, which was associated with an ankle systolic blood pressure of 80 mmHg (ankle-brachial index 0.65). After femoropopliteal bypass surgery normalized blood pressure, the wound remained recalcitrant. A second surgical attempt involving radical debridement and split skin grafting resulted in over 90% graft take and spontaneous healing of the remaining wound.
What This Means for Canadian Patients
This case suggests that for Canadian patients with severe, limb-threatening leg ulcers due to systemic sclerosis, radical debridement combined with a split skin graft could be a viable option. This approach may be considered when other conservative treatments, including hyperbaric oxygen therapy, have not been successful.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
As a single case report, the findings of this study may not be generalizable to a wider patient population.