title: Case studies evaluating transdermal continuous oxygen for the treatment of chronic sickle cell ulcers.
abstract: OBJECTIVE
  Refractory leg ulcerations are common in homozygous sickle cell anemia. In this case series, patients were treated with transdermal continuous oxygen therapy (TCOT), based on the hypothesis that oxygen deprivation caused by arteriovenous shunting may be remedied by providing oxygen directly to the wound bed. The authors believe this is the first attempt to treat sickle cell ulcers with TCOT.
  
  
  METHODS
  Five patients with long histories of recurring sickle cell disease ulcers that would not heal with various conventional and/or other adjunctive wound healing modalities were treated with TCOT. The patients had recurring nonhealing wounds for 30, 21, 20, 20, and 15 years, respectively. All 5 patients healed or showed substantial improvement in the treatment periods of 3 to 36 weeks.
  
  
  CONCLUSIONS
  The authors conclude that TCOT may be a novel, effective, and inexpensive modality in treating patients with sickle cell disease ulcers. Improvement was typically noticeable within 2 weeks. Further clinical trials may be considered to evaluate the efficacy of TCOT in sickle cell ulcers.
authors.affiliation: Ikechukwu Igwegbe, MD, MHA, is Senior Clinical Site Manager, Parexel International Corporation, Waltham, Massachusetts. Gladys Onojobi, MD, is Assistant Professor of Medicine, College of Medicine, and Margaret O. Fadojutimi-Akinsiku, RN, is a Research Nurse, Howard University, Center for Sickle Cell Disease, Washington, DC. Alan M. Hirsh, MD, is Chief Medical Officer and Senior Clinical Instructor, University Hospitals, Ahuja Medical Center, Beachwood, Ohio. Nanjin J. Park, DPM, is a Fellow, Limb Preservation and Wound Care Research, Department of Surgery, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts. Min Yao, MD, MPH, is a Clinical Research Scientist, Department of Surgery, Center for Restorative and Regenerative Medicine, Limb Preservation and Wound Care Research, VA New England Health Care Division, Providence, Rhode Island. Vickie R. Driver, MS, DPM, FACFAS, is Section Chief, Podiatric Surgery, VA New England Health Care Division, Providence, Rhode Island.
authors.forename: Ikechukwu
authors.initials: I
authors.lastname: Igwegbe
authors.forename: Gladys
authors.initials: G
authors.lastname: Onojobi
authors.forename: Margaret O
authors.initials: MO
authors.lastname: Fadojutimi-Akinsiku
authors.forename: Alan M
authors.initials: AM
authors.lastname: Hirsh
authors.forename: Nanjin J
authors.initials: NJ
authors.lastname: Park
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Vickie R
authors.initials: VR
authors.lastname: Driver
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D014945:Wound Healing
chemical_list: D010100:Oxygen