Healing of a Chronic Pressure Injury in a Patient Treated With Medical Cannabis for Pain and Sleep Improvement: A Case Report

Abstract

BACKGROUND: A small body of evidence suggests medical cannabis may facilitate wound healing, but the exact mechanism of this effect is unclear. PURPOSE: This case report describes a patient with a pressure injury (PI) who received cannabis oil treatment for pain management and sleep improvement. METHODS: A 37-year-old woman with multiminicore disease, scoliosis, short-chain acyl-CoA dehydrogenase deficiency, and epilepsy presented to the Neurology Centre of Toronto with chronic pain and sleep disturbance, including difficulty initiating and maintaining sleep. She also had a 5-year history of a PI between her right iliac crest and right rib cage that had progressively worsened. The patient received a medical cannabis oil protocol that used a combination of cannabidiol and tetrahydrocannabinol. RESULTS: Cannabis oil was effective in treating pain and sleep difficulties. Unexpectedly, during the first 2 weeks of treatment, the PI started to heal and was almost completely closed at the 2-month follow-up. CONCLUSION: Although it is unknown if the observed healing of this refractory PI was indirectly or directly related to the cannabidiol and tetrahydrocannabinol treatment, the potential relationships among pain, sleep disturbance, cannabis treatment, and healing should be explored.

The effect of cannabinoids on wound healing: A review

“…Diaz et al 49 published a case report where they described a patient who was treated with oral cannabis oil, which included a combination of CBD and THC, to treat a chronic pressure ulcer.…”

“…A foam padded dressing was the only other intervention applied which may have confounded the effect of the cannabis oil treatment. 49 Maida et al 47,48 possible benefit in both studies, their study design did not include a control group making it difficult to determine if the TCBMs led to the wound closure. 47,48 In another case series, three patients self-initiated various topical formulations of CBD to treat epidermolysis bullosa (EB) lesions.…”

“…Prospective cohort study: patients with nonuremic calciphylaxis leg ulcers who failed other treatments had a good response Maida et al 48 Topical CBD, terpenes, and flavonoids Prospective cohort study: patients with venous leg ulcers who failed other treatments had a good response Diaz et al 49 Oral THC and CBD oils Case report: patient with pressure ulcer refractory to treatment for 5 years improved incidentally after starting CBD and THC oil Schrader et al 50 Topical, oral, and inhaled cannabinoids Cross-sectional survey: patients with epidermolysis bullosa had improvement in their symptoms test assay. The cells were treated with CB 1 and CB 2 antagonists and they noted these effects were likely modulated through both receptors.…”

Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain: A Systematic Review

“…Another study with 2224 patients by Maurer et al revealed that the patients’ post-injury three and four-week use of cannabis after concussions resulted in a lower severity score but not faster recovery from concussion symptoms [ 5 ]. The case report of Diaz et al on a patient with pressure injury exhibiting pain and sleep problems was given with three different medical cannabis oils (1 CBD-dominant and 2 THC-dominant) in increasing doses and revealed an improvement in sleep quality with a decrease in pain and anxiety [ 21 ]. An incidental wound improvement was noticed starting at two weeks post-treatment [ 21 ].…”

“…The case report of Diaz et al on a patient with pressure injury exhibiting pain and sleep problems was given with three different medical cannabis oils (1 CBD-dominant and 2 THC-dominant) in increasing doses and revealed an improvement in sleep quality with a decrease in pain and anxiety [ 21 ]. An incidental wound improvement was noticed starting at two weeks post-treatment [ 21 ]. These studies highlighted different benefits of CBD on different areas of the body, making the potential value of the CBD product even greater.…”