Sequential Use of Hyperbaric Oxygen, Synthetic Skin Substitute and Skin Grafting in the Treatment of a Refractory Vasculitic Ulcer

Akcali, Gökhan; Uzun, Günalp; Yapici, Abdul Kerim; Yıldız, Şenol

doi:10.1016/j.jccw.2015.02.002

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…In a case report, cutaneous leukocytoclastic vasculitis was treated with skin grafting and a 4-week session of HBO therapy; this treatment also achieved an excellent response without recurrence. 23 Although our patient only received a short course of HBO therapy, he did not report any discomfort, and the wound healing process was accelerated. Whether HBO therapy yields a better response in autoimmune diseases than in diabetic or chronic venous ulcers is unclear.…”

Section: Brief Discussionmentioning

confidence: 71%

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Chronic Leg Ulcer Associated with Cutaneous IgG4-Related Disease

Chen

Hsu

Lin

2022

The International Journal of Lower Extremity Wounds

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Chronic leg ulcer occurs in up to 13% of the general population and leads to economic and health care burdens. Approximately 20% of chronic nonhealing wounds are related to autoimmune diseases or vasculitis. Of these, chronic wounds associated with IgG4-related disease, a group of fibroinflammatory disorders that can have cutaneous and systemic involvement, are rarely reported. This case report describes a chronic leg ulcer associated with cutaneous IgG4-related disease. In addition to disease control with anti-inflammatory agents, following the principles of wound management and providing adjuvant wound treatment (eg, debridement, dressing, photobiomodulation therapy, or hyperbaric oxygen therapy) can promote the wound healing process.

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Section: Brief Discussionmentioning

confidence: 71%

Section: Brief Discussionmentioning

confidence: 99%

Chronic Leg Ulcer Associated with Cutaneous IgG4-Related Disease

Chen

Hsu

Lin

2022

The International Journal of Lower Extremity Wounds

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“…Ten articles were identified by handsearching the reference list of included studies. Finally, 102 17‐118 articles were included in this systematic review (Figure 1). The studies included were 53 case reports, 28 case series, 15 letters, and 6 conference abstracts published between 1930 and 2019.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review

Morgenstjerne‐Schwenck

Knudsen

Prasad

2020

Wound Repair Regeneration

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Chronic painful ulcers caused by pyoderma gangrenosum (PG) and cutaneous vasculitis remain to be a therapeutic challenge. Skin grafts have been used with success in selected cases but are generally avoided due to the fear of pathergy. The aim of this study was to investigate the safety and efficacy of skin grafting in the treatment of primary vasculitic ulcer (PVU) and PG. MEDLINE, Embase, the Cochrane Library, http://clinicaltrial.gov, and WHO International Clinical Trials Registry Platform (ICTRP) were searched from inception to March 2020. A search for grey literature was conducted in May 2020. We included studies assessing the efficacy and safety of skin grafting in the treatment of PG and PVU. Studies were only included if skin grafting was performed after establishment of PG or PVU diagnosis. A total of 721 articles was identified through the database search of which 92 were included in this study. Ten articles were identified by handsearching the reference list of included studies. Finally, 102 articles describing 212 wounds in 153 patients were included. Complete healing was found in 75.5% of the wounds. The average time to complete was 10.8 weeks (95% CI 6.1‐15.6). The mean donor site healing time was 1.9 weeks (95% CI 0.52‐3.20). Pathergy was reported in 8 (5.2%) patients. One patient had severe infection related to skin grafting. A statistically significant difference in the number of patients receiving preoperative (P = .0079) and postoperative (P = .002) immunosuppressive therapy was found between the groups with complete healing/reduction and no improvement/aggravation. This systematic review finds the current evidence on efficacy and safety of skin grafting in treatment of PG and PVU to be promising but limited to the size and lack of studies superior to case reports and case series. Future placebo‐controlled trials are required to draw a stronger conclusion.

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“…as well as building up oxygen concentration gradient between wound central area and margins. [37][38][39][40] In case of LASEROBARIA-S device, the regenerative effect of HBO treatment is additionally supported by the activity of variable magnetic field having physical parameters used in magnetotherapy, as well as the activity of low-energy light emitted by LEDs. 18,19 Among the mechanisms of regenerative effect of extremely low- In case of therapy with the use of LASEROBARIA-S device, the analgesic effect of HBO is additionally boosted by the activity of alternating magnetic field, with physical parameters applied in magnetotherapy, as well as by low-energy light radiation emitted by LEDs.…”

Section: Discussionmentioning

confidence: 99%

“…Another mechanism of HBO therapy, which is of substantial importance for accelerating the healing of ulceration is the stimulation of neovascularisation process, which in HBO conditions is evoked by stimulation of VEGF synthesis, which leads to increasing the activity of progenitor cells and intensification of new vessels and stimulation of nitric oxide synthase (NOS) production, with subsequent/secondary increase of nitric oxide (NO) synthesis, which is indispensable for normal course of angiogenesis stimulated by vascular endothelial growth factor (VEGF) 34‐36 . HBO also stimulates the angiogenesis process by increasing the activity of basic fibroblast growth factor (bFGF), as well as building up oxygen concentration gradient between wound central area and margins 37‐40 …”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy, and low‐energy light therapy in the treatment of venous leg ulcers

Pasek

Szajkowski

Pietrzak

et al. 2020

Dermatologic Therapy

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The aim of the study was to compare the therapeutic efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy and low-energy light therapy in the treatment of venous leg ulcers. Thirty-six patients were treated with topical oxygen hyperbaria and 29 patients were treated with a combination of physical methods. The assessment of ulcer surface area with use of a planimetric method, pain intensity with use of Laitinen scale and quality of life by means of EuroQol scale were performed. In both groups a statistically significant (P < .05) reduction of ulcer surface area has been obtained, but in patients treated with combined physical therapy average percentage reduction of ulcer surface area (36.44% ± 11.04%) was statistically significantly (P = .00001) bigger as compared to other group (13.65% ± 8.32%). In both groups of patients statistically significant (P < .05) reduction of frequency and intensity of pain, reduced intake of analgesic drugs and reduction of limitations of physical activity, as well as statistically significant improvement of quality of life have been observed, but in patients treated with combined physical therapy an average increase in the score in EuroQoL scale (61.03 ± 7.14) was statistically significantly (P = .00001) bigger as compared to other group (25.27 ± 8.16). It was concluded that topical hyperbaric oxygen therapy alone and a combination of physical methods cause significant reduction of ulcer surface area, reduction of pain intensity, as well as improvement of the quality of life, but a combination of physical methods is more efficient. K E Y W O R D S chronic wounds, combined physical therapy, quality of life, topical hyperbaric oxygen therapy, venous leg ulcers 1 | INTRODUCTION Venous leg ulcers are a consequence of pathological conditions in venous blood vessels, having complex etiopathogenesis. Among their most frequent underlying causes, one can list venous insufficiency, varicose veins of lower limbs, as well as the history of deep vein thrombosis. The above-mentioned pathologies related to the venous system occur in over 35% of the population, while the venous

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Sequential Use of Hyperbaric Oxygen, Synthetic Skin Substitute and Skin Grafting in the Treatment of a Refractory Vasculitic Ulcer

Cited by 6 publications

References 14 publications

Chronic Leg Ulcer Associated with Cutaneous IgG4-Related Disease

Chronic Leg Ulcer Associated with Cutaneous IgG4-Related Disease

Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review

Comparison of the efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy, and low‐energy light therapy in the treatment of venous leg ulcers

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