Case report – Male, 51 years old
causistic date: 24.06.2008, published: 24. 06. 2008
Dr. Veronika Slonková, Dr. Vladimír Vašků, CSc. (1st Department of Dermatology and Venereology of St. Anne’s University Hospital)
The patient is a 51-year-old male, a driver by profession, who has been treated for recidivation ulcerations on both shinbones for about 20 years. The current ulceration has persisted for 12 months. Phlebitis or erysipelas negated. Short-stretch bandage compression was worn regularly. Epicutane tests proved a contact allergy to chloroacetamide. He is being treated for hyperbilirubinemia, besides that he is healthy. Venous examination proved that these ulcerations were of venous etiology; CVI EI bilat., class C6 by CEAP classification. Pharmacological anamnesis: Detralex, Agapurin retard, Anopyrin. Allergies: no medication.
Objective finding: an ulceration of irregular shape, covering 6.3 cm2, with granulating base and calm surrounding area located above the inner ankle (pic. 1). The patient complained of moderate pain – No. 5 on the NRS (numerical rating scale).
The patient was included in the study of Traumastem biodress (hydrogencalcium salt of oxidized cellulose). Redressing of the ulcerations was performed daily at first and then after 2 – 3 days in a later phase. Before the application of Traumastem, ulcerations were treated with Dermacyn solution with subsequent application of zinc oil around the ulcerations and application of oxidized cellulose in the ulcerations. These were then covered by oily gauze, a layer of gauze and fixed by a hydrophilic bandage and 2 – 3 short-stretch bandages.
The application of Traumastem triggered a gradual epithelization from the edges. After 3 weeks the size of ulceration had diminished by a third (area of 3.7 cm2) (pic. 4).
After 2 months of therapy, the ulceration had diminished to less than a half of its original area (pic.7). The area around the ulceration was calm.
There was a slight reduction of pain during the therapy – see the table below.
| T0 | T1 | T2 | T3 | T4 | T6 | T8 | |
| size of ulceration (cm2) | 6,3 | 5,6 | 5,0 | 3,7 | 3,7 | 3,5 | 2,8 |
|---|---|---|---|---|---|---|---|
| pain (NRS) | 5 | 4 | 4 | 4 | 3 | 4 | 4 |
Note: At the time of the clinical study, Traumastem biodress (hydrogencalcium salt of oxidized cellulose) was called Traumastem T. This information also applies to the galleries of photographic illustrations included in these casuistries.
