title: "Toothbrush" the Feet: A Periodic Mechanical Stimulus for Healing of a Severe Chronic Leg Ulcer.
abstract: Chronic wounds develop when the sequence of healing events are disrupted, usually in patients with underlying diseases such as diabetes mellitus, venous insufficiency, peripheral artery disease, and neuropathies and they affect most often the lower extremities. We present a 68-year-old woman with plantar ulceration, lasting for approximately 18 months, resistant to healing with conventional therapy and various modalities we used. The patient had a long history of seronegative enteropathic arthritis, Crohn's disease, secondary fibrillar amyloidosis, multiplex neuropathy, and small vessel vasculitis, the latter being the trigger event for the ulceration of her right foot. Before the decision for a final surgical intervention, we implemented a mechanical periodic stimulus using a soft toothbrush, which resulted in the gradual and complete healing of the ulcer within a period of 6 weeks. Patient's history and previous treatments are presented along with the procedures that led to the healing of the chronic wound. This report supports the idea that periodic mechanical stimulus is of great importance for the healing process and this could be the mechanism of action of some other methods that have been described in the medical literature.
authors.affiliation: 424 General Military Hospital, Thessaloniki, Greece perivoun@email.com.
authors.forename: Periklis
authors.initials: P
authors.lastname: Vounotrypidis
authors.affiliation: 424 General Military Hospital, Thessaloniki, Greece.
authors.forename: Periklis
authors.initials: P
authors.lastname: Pappas
authors.affiliation: 424 General Military Hospital, Thessaloniki, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Vrangalas
authors.affiliation: 424 General Military Hospital, Thessaloniki, Greece.
authors.forename: Anthimos
authors.initials: A
authors.lastname: Pehlivanidis
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000628:therapy*; D010812:Physical Stimulation / Q000379:methods; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index; D014945:Wound Healing
keywords: Crohn’s disease; amyloidosis; arthritis; chronic leg ulcers; vasculitis