A 25-year-old woman from Brazil with sickle cell disease had a leg ulcer since age 12 that did not heal despite various treatments. When the ulcer grew to 20 cm by 10 cm, doctors in Brazil recommended amputation. After moving to the Netherlands, her ulcer was treated with an alginate dressing, honey dressing, compression, and debridement, but showed no improvement. After starting treatment with topical hemoglobin spray twice a week, the ulcer significantly reduced in size over four months and nearly closed, even as the patient experienced sickle cell crises and was admitted to the ICU. The 14-year old ulcer healed after four months of topical hemoglobin treatment.

1. Annemiek Mooij
Master in Advanced Nursing Practice,
Slotervaartziekenhuis/
Cordaan Thuiszorg
Amsterdam, the Netherlands
(annemiek.mooij@slz.nl)
This work has been made possible by an educational/research grant from BiologiQ,
Distributor of Granulox in the Netherlands.

2. A 25-year old woman, with a history of sickle celldisease,
born in Brazil, suffered a Leg Ulcer since she was 12 years
old. In Brazil she was always treated with
silversulfadiazine cream.
She felt always sad, because of the wound she wasn’t
able to work and to dress nice.
In 2013 she came to the Netherlands after the doctors in
Brazil suggested to amputate her leg.
When we started the treatment the Ulcer was 20 cm by
10 cm, covered with a yellow-grey slough. The wound
was treated with an alginate dressing and later on with a
honeydressing. The edema was treated by compression.
There was no effect. After a month we started treating
the wound with topic hemoglobin.
Start of treatment after debridement

3. Day 24
9,5 x 9,3 cm
Red 90%
Yellow 10%
Secundairy dressing:
Foam
Day 35
8,5 x 7,5 cm
Red 75%
Yellow 25%
Secundairy dressing:
Absorbent
We started treatment of the wound with topic
hemoglobin. It was sprayed on the wound twice a week.
In the following 4 months the wound healed, eventhough
the patient suffered sickle cell crises 4 times.
She was also admitted at the ICU.
This work has been made possible by an educational/research grant from BiologiQ,
Distributor of Granulox in the Netherlands.

4. Day 54
5,0 x 4,5 cm
Red 100%
Lateral side complete
epithelialisation.
Day 131
Wound nearly
closed
From day 74 on slide
Inflammation of the wound.
Starting treatment with
Honeygauze.
3,5 x 2,5 cm
Red 100%
After 131 days the wound was almost closed, apart from
a few very small defects.

5. Conclusion:
In despite of several negativ influences, like
inflammation and multiple sickle cell crises, the
14 years old wound has healed after 4 month!
Using a Topical Hemoglobin spray was in this case
the breaktrough for getting the wound activ again.
The patient was very happy and moved back to Brazil.
Before After
This work has been made possible by an educational/research grant from BiologiQ,
Distributor of Granulox in the Netherlands.