ObjectiveTo explore the value of potaried technique with Trivex system in treatment for venous skin ulcer with deep venous thrombosis sequelae (DVTS) of lower limbs. MethodsTotal 166 patients with venous skin ulcer with DVTS of lower limbs were included in this study. The patients of operation group (94 patients involving 94 legs) were treated by using potaried technique with Trivex system. The patients of nonoperation group (72 patients involving 72 legs) were treated by using nonoperative method. The clinical indexes of skin infection rate, skin necrosis rate, shrinkage rate of wound area, skin depigmentation rate, ulcer healing rate and ulcer recurrence rate were used to assess the clinical curative effect between two groups on 5, 20, 120 and 360 d after operation or treatment, respectively. ResultsThere were no skin infection and skin necrosis in two groups on 5 d after operation or treatment. The rate of shrinkage of wound area and skin depigmentation of patients in operation group were significantly higher than those in nonoperation group on 20 d after operation or treatment 〔(95.8±2.138)% vs. (68.7±3.125)%，P=0.048; (87.6±1.263)% vs. (12.3±1.324)%， P=0.018〕. The rate of the ulcer healing of patients in operation group was significantly higher than that in nonoperation group on 120 d after operation or treatment (97.9%vs. 8.3%， P=0.014). The rate of the ulcer recurrence of patients in operation group was significantly lower than that in nonoperation group on 360 d after operation or treatment (5.3% vs. 97.2%， P=0.015). ConclusionThe potaried technique with Trivex system can be used as one of the surgical treatment methods for venous skin ulcer with DVTS of lower limbs.
Objective To investigate the effect and safety of autologous bone marrow-mononuclear cell (BM-MNC) transplantation on ischemic limb of patients with thromboangiitis obliterans (TAO). Methods Thirteen patients with TAO underwent transplantation of autologous BM-MNC into ischemic muscles of 17 lower limbs. A series of subjective indexes (improvement of pain and cold sensation) and objective indexes including increase of ankle brachial index (ABI), transcutaneous oxygen pressure (TcPO2), and improvement of foot skin ulcer were used to evaluate the effects. Results The outcomes were evaluated after 2 months of transplantation. The pain relief and improvement of cold feeling were in 15 limbs and 16 limbs, respectively. Before transplantation and 2 months after transplantation, ABI was 0.37±0.06 and 0.50±0.17, respectively (Plt;0.05), and TcPO2 of the ischemic legs were (24.59±3.36) mm Hg (1 mm Hg=0.133 kPa) and (35.00±10.44) mm Hg, respectively (Plt;0.05). ABI increased in 9 limbs. TcPO2 elevated in 14 limbs. Skin ulcer improved in 7 limbs. Thirteen patients were followed up from 4 to 18 months (average 8 months), the patients’ symptoms improved in 13 limbs. ABI was 0.45±0.14, which wasn’t different from those before transplantation and 2 months after transplantation (Pgt;0.05). TcPO2 was (33.24±10.43) mm Hg, which was different from those before transplantation and 2 months after transplantation (Plt;0.05) and was elevated in 12 limbs. Skin ulcer healing was in 5 limbs. The ischemic symptoms in 2 patients were not relieved. There was no mortality and high level amputation. The following complications, such as proliferative retinopathy, malignant tumor, myocardial infarction, stroke or hemangioma, were not found in all patients.Conclusion In patients with TAO, intramuscular transplantation of autologous BMMNC is a safe and effective method, and may improve symptoms and accelerate the healing of skin ulcer.