Case report – Male, 81 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 an 81-year-old retired male who has been treated for recurrent ulcerations on the left shinbone for 2 years. The current ulceration has now persisted for 5 months. In his medical history, the patient further lists recurrent microbial eczema on shinbones. Compression is worn regularly. Phlebitis or erysipelas negated. He is being treated for hypertension, hyperlipidemia and glucose tolerance disorder. Venous examination proved that these ulcerations were of venous etiology; CVI EI bilat., class C6 by CEAP classification. Pharmacological anamnesis: Lozap H, Detralex, Agapurin retard
Allergies: salicylates
Objective finding: an ulceration of irregular shape with slightly coated but granulating base, located medially in distal third of the left shinbone. The ulcerated area covered 2.2 cm2 (pic. 1). The patient complained of slight pain – No. 3 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.
Already after a week, the base of the ulceration was completely cleaned and diminished to a half of the original size (area of 1 cm2) (pic. 2). Further development led to a very fast gradual epithelization from the edges; after 3 weeks of therapy there was only a minor ulceration persisting, covering 0.5 cm2 (pic. 4)
After 4 weeks, the ulceration had completely healed (pic. 5).
The patient noticed an immediate relief from pain already after first application – he claimed a zero intensity of pain on the NRS – see the table below.
| T0 | T1 | T2 | T3 | T4 | T6 | T8 | |
| size of ulceration (cm2) | 2,2 | 1,0 | 0,9 | 0,5 | 0 | 0 | 0 |
|---|---|---|---|---|---|---|---|
| pain(NRS) | 3 | 0 | 0 | 0 | 0 | 0 | 0 |
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.
