Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral/epidemiologia , Sociedades Médicas , Centros de Atenção Terciária , Procedimentos Cirúrgicos Vasculares/normas , COVID-19 , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão , SARS-CoV-2 , Estados UnidosRESUMO
We present a case report of intractable multifactorial leg ulcer that was treated successfully with multiple approaches including hyperbaric oxygen treatment (HBOT) to prepare for skin grafting. A 66-year-old female with a history of rheumatoid arthritis and Felty's syndrome presented with a non-healing ulcer on her left leg that was caused by a trauma. She failed multiple treatment options including debridement, different wound dressings, antibiotics, anti-inflammatories and vein closure procedure. She finally healed with skin graft following HBOT that prepared the wound bed before the procedure.
Assuntos
Oxigenoterapia Hiperbárica , Úlcera da Perna/terapia , Transplante de Pele/métodos , Idoso , Feminino , Humanos , Traumatismos da Perna/complicações , Úlcera da Perna/etiologia , Resultado do Tratamento , CicatrizaçãoRESUMO
BACKGROUND: With currently available effective interventional methods to treat superficial venous insufficiency, it becomes particularly important to have a simple and reliable method to evaluate the location and severity of venous reflux. To date, there are few studies that evaluated plethysmography with and without tourniquet application to differentiate superficial from deep venous incompetence. OBJECTIVES: To determine if strain gauge plethysmography (SGP) with and without tourniquet application can be used to distinguish between the superficial and deep venous components of venous incompetence. METHODS: We conducted a prospective study using SGP with and without tourniquet application and duplex ultrasound (duplex US) to assess the severity and location of venous incompetence in 62 patients (85 limbs, 42 women, with an age range of 32-81 years) referred to our vascular laboratory for haemodynamic evaluation. Based on duplex US results, patients were diagnosed with superficial (SVI), deep and superficial (mixed) and deep vein incompetence (DVI). RESULTS: Mixed incompetence was the most common type. Twenty-three out of 33 limbs in the SVI group normalized their refill rate (RR) with tourniquet application (69.6%). Normalization of the RR with tourniquet application was less common in the mixed (n: 17 out of 40, 42.5%) and DVI (n: 2 out of 6, 33.3%) groups. CONCLUSION: SGP with tourniquet application is a simple and fast technique that can identify patients with SVI, based on RR improvement, who probably would benefit more from ablation procedures. Further studies evaluating impact of SGP with tourniquet test results on clinical outcome of SVI invasive treatment are warranted.