Healing of chronic sickle cell disease-associated foot and ankle wounds using transdermal continuous oxygen therapy

Abstract

Objective: Sickle cell disease (SCD) is a complex cause of capillary stasis that can lead to lower extremity venous ulcers. Since SCD is characterised by impaired oxygen delivery that can be exacerbated by lower extremity venous stasis, we sought to determine if direct delivery of oxygen to a lower extremity ulcer associated with SCD could augment healing.

Method: We performed a pilot study of a portable device that delivers oxygen directly to the wound site to assess this possibility. The device was assessed in a single patient with three longstanding wounds of the lower extremities associated with SCD: the lateral right ankle, the medial aspect of the distal left leg, and the dorsal left foot. The left leg and left foot wounds received 15 weeks of treatment each.

Results: Both left lower extremity wounds healed, and neither wound has relapsed in the 42 months since the treatment was completed. At 36 months from the completion of treatment, the patient presented to the hospital with renal failure, and with the 27 days of complete bed rest and wound elevation, the right ankle wound shrunk to 55% of the original wound surface area. Transdermal oxygen appears to have assisted in healing and to have provided a sustained benefit that has delayed relapse of the two SCD-associated leg ulcers that received an extended course of treatment. Similarly, complete bed rest appears to aid in the healing of SCD-associated leg ulcers. Further study is needed to determine the mechanism of action and the optimal method of use of the transdermal continuous oxygen delivery device for SCD-associated lower extremity ulcers.

Declaration of interest: No competing financial interests exist for any author. The content of this article was expressly written by the authors listed. No ghostwriters were used to write this article.

Keywords: oxygen; sickle cell disease; ulcers; venous stasis.