Transversal escharotomies: a new surgical technique adjuvant in the treatment of chronic ulcers with non-arterial etiology in the lower limbs.
OBJECTIVE
Propose a new and alternative surgical procedure in order to aid on treatments of chronic ulcers with non-arterial etiology in the lower limbs, especially those that reoccurs and accomplish of dermatosclerosis and skin contractures determining ankle and foot limits.


METHODS
It describes a medical case regarding a female, 54 years old, with a pre-existing ulcer (sixteen years) on her left leg. Despite of conventional treatments such as curatives, compressive therapy and surgeries, the ulcer on her leg was not cured for three years. The skin dermatosclerosis on her foot and ankle limited her mobility tremendously. The surgery involved the debridement of the ulcers, local phlebectomies and the correction of her scar contraction by a transversal escharotomies. Conventional procedures were applied in pre and post-surgery.


RESULTS
After twelve weeks, the ulcer was completely healed by second intention. Despite the odds, she regained sustainable mobility in her foot and ankle, allowing this patient to wear medical elastic socks. Reoccurrences of the ulcer did not occur during the two years post-surgery.


CONCLUSIONS
The transversal escharotomies may favor the healing of non-arterial chronic ulcers in the lower limbs, impeding perpetual mechanisms of this sort. For example, the ankle and foot limitation determinates in secondary scars, skin contractures, dermatosclerosis that produce the failure in the muscular calf-pump with deterioration in the ascending venous propulsion.
Freitas
Mário Augusto Silva
MA
Department of Health and Biological Science, UFMS, Brazil. amugus@terra.com.br
Julião
Maria do Carmo Cardia
Mdo C
D002908:Chronic Disease; D003286:Contracture / Q000601:surgery; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D012008:Recurrence; D014647:Varicose Ulcer / Q000517:prevention & control / Q000601:surgery*; D014945:Wound Healing