두겹 압박방식 3MTM CobanTM을 이용한 울혈성 정맥궤양의 치료: 증례보고

Abstract

Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M CobanTM 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and 3 × 4 cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 CobanTM 2 Layer Compression Systems were used. The size of the ulcer decreased to 2.5 × 2.5 cm in one month, to 2 × 2 cm in 2 months, it was 1 × 1.8 cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M CobanTM 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.