Druckulkus unter Kompressionstherapie bei Neuropathie und arteriellem Verschluss

We report about a case of a female patient developing an ulcer with osteomyelitis in a foot following complex physical therapy.For treatment of an iatrogenic stage II lymphoedema in the left lower limb and foot a phase 1 therapy (decongestion) including daily manual lymphatic drainage (MLD) and compression bandaging was initiated. During the course of treatment a pressure ulcer at the left lateral border of the foot occurred.After receiving resection, polychemotherapy and radiation of a synovial sarcoma in the left popliteals cavity 22 years before, and undergoing a reconstruction of the left popliteal artery, additional polyneuropathy persisted, thus an occlusion of the popliteal artery stayed asymptomatic up to that point of time.The pressure in the left foot was increased due to compression bandaging and stockings, which were used according to guidelines. In the context of the insufficient perfusion of the tissue the treatment though caused the development of an infected pressure ulcer with osteomyelitis.As a result of interventional recanalisation of the arterial flow, regional surgical measures with partial amputation of the left fifth metatarsal bone and systemic antibiotic treatment the healing of the ulcer was achieved.

Automated summary

We report a case of a female patient who developed an ulcer with osteomyelitis in her foot following complex physical therapy. The patient had previously undergone resection, polychemotherapy, and radiation for synovial sarcoma in her left popliteal cavity and had undergone reconstruction of her left popliteal artery. The use of compression bandaging and stockings increased pressure on the left foot, leading to insufficient tissue perfusion and the development of an infected pressure ulcer with osteomyelitis.