MANAGEMENT OF AN ATYPICAL VASCULAR
ULCER WITH TLC-NOSF DRESSINGS*
M. NOU, A. KHAU VAN KIEN, T. BEHAR, D. LABAU, C. ZAPPULL...
80 year-old woman presenting three ulcers for the past two months, located on the
external malleolus and the top of the le...
Paraclinical aspects: ABI = 1.2, the arterial ultrasound and TCPO2 are normal, the
venous ultrasound reveals moderate inco...
Surgical desloughing and
introduction of negative pressure
therapy (NPT) for 3 weeks.
Development of purpuric lesions and
...
We suspected cutaneous vasculitis and performed a skin biopsy, which confirmed stasis
dermatitis compatible with a seconda...
Healing course under TLC-NOSF dressing*
After 3 weeks of treatment, we observed a
highly satisfactory result: necrosis 0%,...
This patient presented atypical venous ulcers, initially leading us to suspect necrotic
angiodermatitis then cutaneous vas...
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EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DRESSINGS*

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M. NOU, A. KHAU VAN KIEN, T. BEHAR, D. LABAU, C. ZAPPULLA, S. MESTRE-GODIN
J.P. LAROCHE and I. QUÉRÉ (1), M. MARTIN (2)

(1) Vascular Medicine, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France
(2) Laboratoires URGO, Chenôve, France

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EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DRESSINGS*

  1. 1. MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DRESSINGS* M. NOU, A. KHAU VAN KIEN, T. BEHAR, D. LABAU, C. ZAPPULLA, S. MESTRE-GODIN J.P. LAROCHE and I. QUÉRÉ (1) M. MARTIN (2) (1) Vascular Medicine, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France (2) Laboratoires URGO, Chenôve, France *Brand name: the TLC-NOSF dressing is UrgoStart®
  2. 2. 80 year-old woman presenting three ulcers for the past two months, located on the external malleolus and the top of the left foot and having developed spontaneously. History: varicose disease, necrotic angiodermatitis, pulmonary embolism, depression and hip replacement. Clinical aspects: good general condition, no fever. Suspended, round ulcers that are not very painful, slough 95%, necrotic edges on one of the ulcers 5%, granulation tissue 0%, epithelialisation 0%, very inflammatory halo, low exuding. CASE STUDY
  3. 3. Paraclinical aspects: ABI = 1.2, the arterial ultrasound and TCPO2 are normal, the venous ultrasound reveals moderate incontinence of the left small saphenous vein. Diagnostic hypotheses: secondarily infected venous ulcers or necrotic angiodermatitis. Treatment: desloughing using hydrogel then electrostimulation for 3 weeks. Disappointing result: slough 100%, necrosis 0%, granulation tissue 0%, epithelialisation 0%. CASE STUDY
  4. 4. Surgical desloughing and introduction of negative pressure therapy (NPT) for 3 weeks. Development of purpuric lesions and persistence of pain. Necrosis 0%, slough 20%, granulation tissue 80%, epithelialisation 0%. CASE STUDY
  5. 5. We suspected cutaneous vasculitis and performed a skin biopsy, which confirmed stasis dermatitis compatible with a secondarily infected venous ulcer. Treatment included application of venous compression using multilayer bandages and antibiotic therapy. Subsequently, buried chip skin grafting was performed, but the result was disappointing since only 3 grafts took and the ulcers had not improved for several weeks and had never reduced in size throughout the hospitalisation period. Introduction of TLC-NOSF dressing* on the day of the patient’s discharge from hospital and discontinuation of antibiotics. CASE STUDY *Brand name: the TLC-NOSF dressing is UrgoStart®
  6. 6. Healing course under TLC-NOSF dressing* After 3 weeks of treatment, we observed a highly satisfactory result: necrosis 0%, slough 0%, granulation tissue 50% and epithelialisation 50%. Venous compression was maintained throughout the duration of treatment with TLC- NOSF dressing*. 6 weeks after the patient’s discharge from hospital, the ulcer had healed. CASE STUDY *Brand name: the TLC-NOSF dressing is UrgoStart®
  7. 7. This patient presented atypical venous ulcers, initially leading us to suspect necrotic angiodermatitis then cutaneous vasculitis. Biopsy of the ulcer confirmed the venous aetiology, but successive treatments by electrostimulation then NPT did not lead to any improvement in the appearance of the wound. In addition, buried chip skin grafting performed following surgical desloughing, combined with venous compression, also failed. The application of a TLC-NOSF dressing*, combined with venous compression using multilayer bandages, stimulated healing, with recovery obtained in 6 weeks. CONCLUSION *Brand name: the TLC-NOSF dressing is UrgoStart®

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