Hypertensive ulcer of lower extremity (Martorell's syndrome): clinical case with the treatment improvement

Abstract

Introduction. Martorell's syndrome (MS) is a rare disease associated with chronic progressive hypertension which complicates ulcer defects on the extremities. It requests individual approach to treatment with antihypertensive medications, which help to reduce pathogenesis of the ulceration development. Therefore the aim of this study was to find new treatment methods of this disease. Case presentation. A 83-year-old female Ukrainian patient presented with an ulcer on the right calf, which was extremely painful at night. After all examination it was diagnosed: stage 2 hypertension, high risk, Martorell's syndrome, right lower limb trophic ulcer of the hypertonic genesis. For the treatment of MS we used the combination therapy, which included tissue suturing on the whole area of the ulcer and auto-dermoplasty with PRP applications. After that was noted intense regenerative processes and recovery of the patient. Conclusions. Chronic leg ulcers are rarely caused by Martorell's syndrome. It requires the complex approach to the treatment under obligatory antihypertensive therapy with its further prolongation. The complex therapy improved by the platelet-rich auto plasma activates the therapeutic effect, which results in intensive healing of the ulcer and faster improvement in pain relief. The platelet-rich auto plasma may become an economic method of treatment the ulcers of any genesis.

Role of infection in wound healing

“…Chronic wounds are estimated to develop in 1-2% of the population of developed countries during their lifetime 9 . Along with local causes various systemic diseases such as hypertension 10 are linked with chronic wounds. When superficial skin layer (epidermis) is lost along with dermis or deeper layers, we call this a wound or an ulcer.…”

Efficacy of the Otago exercise programme as a supplementary intervention to exercise classes: On falls, balance, physical function and mobility in a patient with chronic lower back pain: A case report.

“…This arises as patients with chronic low back pain have variable effects on postural activation of superficial abdominal muscles and consistent effect on postural activation of the deepest abdominal muscle which could lead to muscle imbalance and poor activities of daily living 7 . Falls associated with low back pain generally relate to instability of the spine leading to altered gait pattern and imbalance 1,8 . Group or home based exercise programs for older people can be beneficial in preventing falls, improving balance and enhancing physical function 9,10 .…”