Rl. Bick et Rg. Scott, Stasis ulcers refractory to therapy - Accelerated healing by treatment with clopidogrel +/- dalteparin: A preliminary report, CL APPL T-H, 7(1), 2001, pp. 21-24
Stasis ulcers are commonly the result of chronic venous insufficiency. We h
ave recently assessed 15 patients with stasis ulcers that failed to heal af
ter one year of routine wound care. All patients demonstrated a defect in h
emostasis, and a biopsy revealed livido vasculitis. Eleven of fifteen patie
nts were treated with clopidogrel and dalteparin, and 4 of 15 patients were
treated with clopidogrel alone. Thirteen of fifteen patients (86.6%) compl
etely healed within three months of starting antithrombotic therapy. Patien
ts with stasis ulcers and chronic venous insufficiency who fail to heal wit
h routine around care should be subjected to biopsy, a procoagulant defect
evaluation, and initiation of clopidogrel and dalteparin therapy if a defec
t is found.