SICKLE as a holistic treatment approach to sickle cell disease related ulcers

Abstract

This article introduces a simple approach to adopt in the treatment of sickle cell disease (SCD) related ulcerations based on the acronym SICKLE, standing for Skin assessment, Infection control, Compression, Keep moving keep debriding, Local strapping and Endless support. This case report explains and describes each step used in the treatment of this challenging disease in a 24-year-old patient, achieving complete healing in 6 months in long-lasting SCD ulceration previously treated without results with many other treatments. It has been replicated in further patients with excellent results. The SICKLE approach is an attempt to deliver a holistic way of treating patients with SCD-related leg ulcers. More studies are needed to better define the scientific validity of this method or to demonstrate any inconsistencies.

A service evaluation to examine the use of compression strapping for the management of patients with retromalleolar leg ulcers in a specialist community setting

“…Previous observational studies have suggested that the addition of CS can increase the pressure at the retromalleolar area, promote healing, reduce pain, and increase QoL. 28 , 35 , 36 , 37 However, the evidence evaluating the use of CS is limited.…”

“…Previous observational studies have suggested that the addition of CS can increase the pressure at the retromalleolar area, promote healing, reduce pain, and increase QoL. 28,[35][36][37] However, the evidence evaluating the use of CS is limited. This service evaluation set out to evaluate the use of CS to treat patients with retromalleolar LU in a specialist leg ulcer clinic.…”

“…The addition of CS has been demonstrated to enhance compression therapy and promote healing in patients with retromalleolar ulcers, reduce pain, and improve quality of life (QoL) by increasing the sub‐bandage pressure at the lateral and medial retromalleolar fossa. 28 , 35 , 36 , 37…”

“…The pioneers of the strapping technique have since adapted the technique further and have recommended that the application can also be applied in a chevron shape (Figure 2). The addition of CS has been demonstrated to enhance compression therapy and promote healing in patients with retromalleolar ulcers, reduce pain, and improve quality of life (QoL) by increasing the sub‐bandage pressure at the lateral and medial retromalleolar fossa 28,35‐37 …”

“…The addition of CS has been demonstrated to enhance compression therapy and promote healing in patients with retromalleolar ulcers, reduce pain, and improve quality of life (QoL) by increasing the sub-bandage pressure at the lateral and medial retromalleolar fossa. 28,[35][36][37] The Solent Tissue Viability Team introduced the use of CS in October 2018, and subsequently, a service evaluation was conducted to evaluate the use of CS and to inform local decision-making with regard to its continued use. The evaluation aimed at describing the characteristics of the patients who were treated with strapping and at determining the effect of CS on their outcomes of healing, pain, and QoL.…”