Interventions for treating leg ulcers in people with sickle cell disease

Martí‐Carvajal, Arturo J; Knight‐Madden, Jennifer; Martinez-Zapata, María José

doi:10.1002/14651858.cd008394.pub4

Cited by 7 publications

(4 citation statements)

References 141 publications

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“…32 Isolated case reports have described its beneficial effects in leg ulcer patients 33 ; however, no significant effects were noted in the only pilot randomized trial performed, 34 which was described as low quality by a Cochrane review. 35 Elevation of carnitine in the serum of healed patients in this study may potentially suggest increased carnitine levels at the ulcer site to support the generation of new cells and healing 36 ; this may also explain the reduced ceramide, sphingomyelin, and phosphatidylethanolamine levels, which are cell membrane components. 37 Alternatively, elevated L -carnitine levels may suggest an improved ability to respond to trauma and recover from injury; dysregulated plasma carnitine levels have been described in malnutrition and chronic disease.…”

Section: Discussionmentioning

confidence: 74%

Metabolic Profiling Reveals Changes in Serum Predictive of Venous Ulcer Healing

et al. 2023

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Objective: The aim of this study was to identify potential biomarkers predictive of healing or failure to heal in a population with venous leg ulceration. Summary Background Data: Venous leg ulceration presents important physical, psychological, social and financial burdens. Compression therapy is the main treatment, but it can be painful and time-consuming, with significant recurrence rates. The identification of a reliable biochemical signature with the ability to identify nonhealing ulcers has important translational applications for disease prognostication, personalized health care and the development of novel therapies. Methods: Twenty-eight patients were assessed at baseline and at 20 weeks. Untargeted metabolic profiling was performed on urine, serum, and ulcer fluid, using mass spectrometry and nuclear magnetic resonance spectroscopy.Results: A differential metabolic phenotype was identified in healing (n = 15) compared to nonhealing (n = 13) venous leg ulcer patients. Analysis of the assigned metabolites found ceramide and carnitine metabolism to be relevant pathways. In this pilot study, only serum biofluids could differentiate between healing and nonhealing patients. The ratio of carnitine to ceramide was able to differentiate between healing phenotypes with 100% sensitivity, 79% specificity, and 91% accuracy. Conclusions: This study reports a metabolic signature predictive of healing in venous leg ulceration and presents potential translational applications for disease prognostication and development of targeted therapies.

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Section: Discussionmentioning

confidence: 74%

Metabolic Profiling Reveals Changes in Serum Predictive of Venous Ulcer Healing

et al. 2023

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“…An arginineglycine-aspartic acid peptide matrix is supposed to act as a synthetic extracellular matrix to promote cell migration, keratinocyte layer formation, and wound healing. 53,54 Another RCT included use of Solcoseryl ointment (containing protein-free calf blood extract) in combination with a hydrocolloid dressing in 32 patients with SCD and leg ulcers for 12 weeks. Both treatments were compared with a control procedure in which ulcers were cleaned with a slight antiseptic agent, Eusol, and covered by a wet dressing.…”

Section: Topical Treatmentsmentioning

confidence: 99%

“…After 8 weeks, the surface area of treated ulcers significantly decreased compared with the control group. An arginine-glycine-aspartic acid peptide matrix is supposed to act as a synthetic extracellular matrix to promote cell migration, keratinocyte layer formation, and wound healing 53,54 …”

Section: Treatment and Managementmentioning

confidence: 99%

Common, But Neglected: A Comprehensive Review of Leg Ulcers in Sickle Cell Disease

Sahu

Verma

Ganguly

et al. 2021

Adv Skin Wound Care

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OBJECTIVE To compile available evidence to better understand the management of leg ulcers in sickle cell disease (SCD), as well as describe potential therapeutic steps that may be required to improve the quality of life of patients with SCD leg ulcers. DATA SOURCES MEDLINE, PubMed, EMBASE, and Web of Science databases STUDY SELECTION A comprehensive search was conducted to retrieve relevant studies using the keywords “sickle cell disease and leg ulcer,” “ulcer treatments, diagnosis and sickle cell,” and “wound sickle cell.” Studies published through July 2020 were included. DATA EXTRACTION Two independent authors selected all studies that assessed the relationship between leg ulcer and SCD identified from online databases. DATA SYNTHESIS The authors have summarized updated information on pathophysiology (vasculopathy linked to chronic hemolysis and endothelial dysfunction), diagnosis, and available treatment options to unravel the dermohematologic connection between leg ulcers and SCD. CONCLUSIONS It is the authors’ hope that this detailed discussion of the information available on leg ulcers and SCD will lead to a better appreciation of this clinical problem by the clinicians and researchers and in turn have a long-term positive effect on the quality of life of patients with SCD. Researchers should design new trials considering these insights and potential therapeutic approaches based on current knowledge.

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“…The patient was scheduled to undergo an exchange protocol at 3-month intervals with target Hgb of 9 g/dL and Hgb S of <30%. While the patient was undergoing transfusion therapy, hydroxyurea was interrupted so as not to impair tissue repair [ 1 , 2 , 3 , 4 ]. In addition, local wound care and oral zinc therapy were applied.…”

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confidence: 99%