Document Detail


Use of intermittent pneumatic compression for treatment of upper extremity vascular ulcers.
MedLine Citation:
PMID:  16079925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ischemic vascular ulcerations of the upper extremities are an uncommon and frequently painful condition most often associated with scleroderma and small vessel inflammatory diseases. Digital amputation has been advocated as primary therapy because of the poor outcome with medical care. Intermittent pneumatic compression (IPC) pump therapy can improve ulcer healing in lower extremity ischemic ulcerations; however, the value of this treatment in upper extremity ischemic ulcerations is not known. This observational pilot study consisted of a consecutive series of 26 patients with 27 upper extremity ischemic vascular ulcers seen at the Mayo Gonda Vascular Center from 1996 to 2003. Inclusion criteria were documented index of ulcer size and follow-up ulcer size and use of the IPC pump as adjunctive wound treatment. Twenty-six of 27 ulcers (96%) healed with the use of the IPC pump. Mean baseline ulcer size was 1.0 cm2 (SD=0.3 cm2) and scleroderma was the underlying disease in 65% (17/26) of cases. Laser Doppler blood flow in the affected digit was 7 flux units (normal greater than 100). The mean ulcer duration before IPC treatment was 31 weeks. The average pump use was 5 hours per day. The mean time to wound healing was 25 weeks. Twenty-five of 26 patients reported an improvement in wound pain with pump use. Intensive IPC pump use is feasible and associated with a high rate of healing in upper extremity ischemic ulcers. A prospective, randomized, sham-controlled study of IPC is needed to determine whether IPC treatment improves wound healing compared to standard medical care.
Authors:
David H Pfizenmaier; Steven J Kavros; David A Liedl; Leslie T Cooper
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Angiology     Volume:  56     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:    2005 Jul-Aug
Date Detail:
Created Date:  2005-08-04     Completed Date:  2005-09-29     Revised Date:  2005-11-09    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-22     Citation Subset:  IM    
Affiliation:
Division of Vascular Medicine and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Capillaries / physiology
Female
Humans
Intermittent Pneumatic Compression Devices*
Laser-Doppler Flowmetry
Male
Middle Aged
Pilot Projects
Regional Blood Flow
Retrospective Studies
Scleroderma, Systemic / complications
Ulcer / etiology,  therapy*
Upper Extremity / blood supply
Vascular Diseases / etiology,  therapy*
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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