Babadagi-Hardt Zeynep, Engels Peter, Kanya Susanne
die pflegezentrale GmbH, 47138 Duisburg, Bahnhofstr. 20-22, Germany;
EngelsConsult, Gartenstr. 25, 51429 Bergisch Gladbach, Germany;
J Dermatol Case Rep. 2014 Mar 31;8(1):20-3. doi: 10.3315/jdcr.2014.1165.
Although the underlying primary cause of chronic wounds may vary, a common etiology of this is a hypoxic or ischemic status of the affected tissue of the lower extremities. In particular, for rare diseases associated with disturbed blood flow a correlation between cause and effect is often diagnosed inappropriately. As a consequence, chronic wounds may develop and persist for years.
We present a case of a patient with chronic venous insufficiency due to an occlusion of the inferior caval vein. Initially, a Budd-Chiari syndrome was diagnosed which is a thrombotic obstruction of the hepatic venous outflow. In addition, the patient developed an obstruction of the inferior caval vein and subsequently a chronic venous insufficiency. As a consequence, chronic leg ulcers developed with a history of more than 7 years. Various wound care approaches were performed without success in wound closure. Finally, a combination of compression therapy and topical application of a hemoglobin solution successfully led to fast and persistent wound closure.
Chronic ulcers of the lower limb such as venous leg ulcers, even for patients with rare disorders like Budd-Chiari syndrome, are associated with oxygen supply disturbances resulting in a hypoxic status of the affected tissue. Therefore, an adequate oxygen supply to chronic wounds plays a pivotal role in successful wound healing. Compression therapy in combination with enhancement of the local oxygen supply by topically applied hemoglobin showed marked improvement of wound healing in the presented patient.
尽管慢性伤口的潜在主要病因可能各不相同，但常见病因是下肢受影响组织的缺氧或缺血状态。特别是，对于与血流紊乱相关的罕见疾病，因果关系往往被错误诊断。因此，慢性伤口可能会出现并持续数年。
我们报告一例因下腔静脉闭塞导致慢性静脉功能不全的患者。最初诊断为布加综合征，即肝静脉流出道的血栓性梗阻。此外，患者还出现了下腔静脉梗阻，随后发展为慢性静脉功能不全。结果，患者出现了长达7年以上的慢性腿部溃疡。采用了各种伤口护理方法，但伤口均未成功愈合。最后，压迫疗法与局部应用血红蛋白溶液相结合，成功实现了伤口快速且持久的愈合。
下肢慢性溃疡，如静脉性腿部溃疡，即使对于患有布加综合征等罕见疾病的患者，也与氧气供应紊乱有关，导致受影响组织处于缺氧状态。因此，为慢性伤口提供充足的氧气供应在伤口成功愈合中起着关键作用。在本病例中，压迫疗法与局部应用血红蛋白增强局部氧气供应相结合，显著改善了伤口愈合情况。
