Case 131: Small Resistant Stasis Ulcer Helped over Seventeen Days

This 62 year old painter had a half pack of cigarettes a day addiction, a family history of "vein problems," a personal history of phlebitis ten years previously and a 10-15 year history of varicose veins. He had worn support stockings intermittently for ten years. He related his current leg ulcer to hitting his shin against a ladder on the job. He had been under his family doctor's care for two months; the latter had recommended rest and various local measures. His history and leg pigmentation pointed to stasis disease. His vascular tests documented concomitant arterial disease: while his arm blood pressure was 120/68, his left ankle pressures were 60, 80 and 0 mm Hg in the anterior tibial, posterior tibial and peroneal arteries respectively. .

He received 10 Long-Boot therapies over 17 days as an outpatient. A wet-to-dry dressing containing Sea Soaks and gentamicin was applied over his ulcer during the therapy. His leg did well and he returned to work disappearing before he had posed for his follow-up photograph.

Six months later he returned to the office for a neck and arm problem. His leg had remained healed and he posed for his picture.

Comments: Small troublesome stasis lesions can do well rather quickly and then remain healed a surprisingly long time in spite of neglect. Here this painter returned to work and still did well. We think that if they return for therapy before their legs ulcerate when they first begin to notice pain, we can abort the ulcer process and save them both grief and expense. Some of our referring physicians seem to think that booting is indicated only for gigantic leg lesions. In this and the preceding cases, we are showing that small lesions do well also. Again, most of those large lesions started as small ones.