用 Rheocarna 成功治疗一例并发中度骨髓炎和蜂窝组织炎的难治性足跟溃疡病例

IF 0.9 Q3 SURGERY World Journal of Plastic Surgery Pub Date : 2023-01-01 DOI:10.61186/wjps.12.3.106
Makoto Shimabukuro, Naohiro Ishii, Takanori Ko, Kyoichi Matsuzaki, Kazuo Kishi
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引用次数: 0

摘要

血管重建手术最初被考虑用于治疗严重肢体缺血(CLI)患者的溃疡。然而,它可能不适用于严重感染或外周血管闭塞的患者。虽然血液净化疗法是此类患者的辅助疗法,但由于保险范围的问题,该疗法尚未得到广泛应用。我们报告了一例患有中度骨髓炎和蜂窝组织炎的难治性足跟溃疡患者,该患者无法接受血管重建治疗。使用吸附性血液净化剂 rheocarna®(Kaneka Corporation;日本大阪)治疗后,溃疡完全上皮化并控制了炎症。虽然这个病例需要仔细随访,但我们相信,对于血管重建无效的 CLI 患者来说,rheocarna 可能是一种很有前景的治疗选择。Rheocarna 可以改善外周血流,并通过改善抗生素药物输送来控制炎症。
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A Case of Refractory Heel Ulcer Complicated by Moderate Osteomyelitis and Cellulitis Successfully Treated with Rheocarna.

Revascularization surgery was first considered for the treatment of ulcers in patients with critical limb ischemia (CLI). However, it may not be indicated for patients with severe infections or peripheral vascular occlusions. Although blood purification therapy is adjuvant therapy for such patients, it is not yet widely used due to insurance coverage. We report a case of a refractory heel ulcer with moderate osteomyelitis and cellulitis that was not amenable to revascularization. Treatment with the adsorptive blood purifier rheocarna® (Kaneka Corporation; Osaka, Japan) resulted in complete epithelialization of the ulcer and control of inflammation. Although this case required careful follow-up, we believe rheocarna might be a promising treatment option for patients with CLI who do not respond to revascularization. Rheocarna could improve peripheral blood flow and control inflammation by improving antibiotic drug delivery.

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