Document Detail

A case of von Willebrand disease discovered during treatment of a sacral pressure ulcer.
MedLine Citation:
PMID:  21206146     Owner:  NLM     Status:  MEDLINE    
A sacral pressure ulcer developed in a patient hospitalized for cerebral infarction. Each time necrotic tissue was debrided from the ulcer, pressure hemostasis was necessary to stop the bleeding. As treatment continued, the pressure required to stop the bleeding caused the ulcer to worsen, leading to a downward spiral in the patient's condition. While trying to determine the cause of this problem, we discovered that the patient had von Willebrand disease. Medication controlled the bleeding, and the pressure ulcer began to heal at the same time. It was clear to us that conservative treatment would lead to a complete cure but that the healing process would take a long time and require continued administration of an expensive drug. We decided, therefore, to close the wound with a fasciocutaneous flap so that the patient could be quickly transferred to a rehabilitation hospital. About 1 month after surgery, epithelialization was complete, we were able to discontinue medication, and the patient was discharged. This experience demonstrates the importance of determining the cause of any deviation from the normal course of healing in pressure ulcers. It also indicates that the use of fasciocutaneous flaps, which involve little intraoperative bleeding in short surgeries, is appropriate in cases like this one.
Masahiro Murakami; Sumiko Fukaya; Masaichi Furuya; Hiko Hyakusoku
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of Nippon Medical School = Nippon Ika Daigaku zasshi     Volume:  77     ISSN:  1345-4676     ISO Abbreviation:  J Nippon Med Sch     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-01-05     Completed Date:  2011-01-25     Revised Date:  2012-09-25    
Medline Journal Info:
Nlm Unique ID:  100935589     Medline TA:  J Nippon Med Sch     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  325-7     Citation Subset:  IM    
Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
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MeSH Terms
Middle Aged
Pressure Ulcer / complications,  therapy*
Surgical Flaps
von Willebrand Diseases / complications*

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

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