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CASE PROFILE
Diagnosis: Thrombophlebitis (Left Lower Extremity) with Multiple Dermal Ulcers (Both Lower Extremities)
History:
- Approximately 12 weeks prior to presentation at Meditech Laser Rehabilitation Centre, the patient was admitted to hospital with a presumptive diagnosis of necrotizing fasciitis
- Multiple biopsies were carried out and cultures had revealed the presence of Staphylococcus aureus-G
- Hospitalized approximately twelve weeks*
- No improvement of ulcers despite intensive therapy in the hospital, including:
- oral and intravenous antibiotics
- daily dressing changes
- hyperbaric chamber
- analgesics
- daily dressings
Physical Examination on Presentation at Meditech Clinic:
- Severe dermal breakdown and lesions
- Circumference of right mid-calf 6cm greater than the left
- Both legs were painful, the right being most severely affected
Treatment at Meditech Rehabilitation Clinic:
- All wounds left open
- Elimination of all medications except analgesics p.r.n.
- Saline compresses periodically
- Laser therapy
Figures:
- Fig. I to III – Prior to initiating therapy
- Fig. IV to V – After 8 treatments
- Fig. VI – After 23 treatments
Outcome After 23 Treatments:
- All ulcers healed
- Diameter mid-calf equal bilaterally
* patient discharged himself against medical advice
** It should be noted that this patient was not highly compliant, however despite this, he responded well to laser therapy. Lack of compliance is sometimes a byproduct of the psychological change in people with severe chronic problems.
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