Alcohol neurolysis of the sciatic and femoral nerves to improve pressure ulcer healing.
Successful pressure ulcer treatment is challenging and is often plagued with prolonged hospitalizations, multiple surgeries, and high recurrence rates. Pressure ulcer secondary to spinal cord injury is further complicated by spasticity, which contributes to both ulcer continuance and healing. This report illustrates the use of neurolytic regional techniques for spasticity control and pressure ulcer healing.


METHODS
We present our experience with a paraplegic man who suffered from chronic right trochanteric and ischial pressure ulcers that failed to heal despite surgical and conservative treatment. We report the successful treatment of knee and hip flexor spasticity with a femoral and sciatic alcohol neuroablation technique. It was not until the successful control of his lower extremity spasticity that the pressure ulcers showed signs of healing. Neuroablation nay be considered for spasticity control when more conservative approaches fail or are not feasible.
Wilkes
Denise
D
Department of Anesthesiology and Pain Management, University of Texas Medical Branch, Galveston, Texas 77555, USA. dwilkes@utmb.edu
Ganceres
Natalie
N
Doulatram
Gulshan
G
Solanki
Daneshvari
D
D000431:Ethanol; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000628:therapy; D009407:Nerve Block / Q000379:methods*; D003668:Pressure Ulcer / Q000628:therapy*; D012584:Sciatic Nerve
D000431:Ethanol