HYPERTENSIVE ISCHEMIC ULCERS - TREATEMENT WITH EARLY SPLIT SKIN-GRAFTS

Introduction. Necrotic angiodermitis is an uncommonly hypertensive isc hemic ulceration. It usually occurs on the legs in elderly, hypertensi ve and sometimes diabetic patients. Its extensive and highly painful n ature is characteristic. Currently, there is no simple effective treat ment which is known to stop the development. We report the results of a patch graft method applied early before the angiodermitis develops i nto an advanced stage. Patients and methods. The technique was used in 13 consecutive patients with 16 episodes of necrotic angiodermitis. T he graft was made 8 days (mean) after hospitalization. Results. The an algesic effect of the graft was apparent within the first days after t he graft. The violet halo of extension disappeared a mean of 8 days af ter the graft. A second or even third graft was required in 8 of 16 ep isodes. Total cicatrization was obtained after a mean delay of 33 days . Conclusion. Patch graft is a simple, low-cost, non invasive treatmen t which can be performed at the bedside and even in an outpatient clin ic. This stops the extension of the necrotic angiodermitis and control s pain. Delay to cicatrization is shorter. The favourable effect of th e graft could possibly be mediated by vasodilator peptides liberated b y the graft tissue which would counteract the hypothetical vasospasm.