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[Retrograde venous perfusion (RVP in ulcero-mutilating neuropathy].

M Brunner1, H D Göring

  • 1Hautklinik und Immunologisches Zentrum des Städtischen Klinikums Dessau, Auenweg 38, 06847 Dessau.

Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete
|November 22, 2001
PubMed
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Retrograde venous perfusion (RVP) offers a novel treatment for ulcero-mutilating neuropathy. This method improved ulcer healing and reduced inflammation in patients with this complex foot condition.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Dermatology

Background:

  • Ulcero-mutilating neuropathy presents as painless foot ulcers, lower leg polyneuropathy, and forefoot osteolysis.
  • Commonly affects middle-aged men with diabetes, liver disease, alcoholism, obesity, or foot deformities.
  • Systemic antibiotic delivery is limited by compromised microcirculation in affected limbs.

Purpose of the Study:

  • To evaluate the efficacy of retrograde venous perfusion (RVP) for treating ulcero-mutilating neuropathy.
  • To determine if RVP can improve drug delivery to damaged tissues and enhance therapeutic outcomes.

Main Methods:

  • A solution of netilmycin, gentamycin, buflomedil, heparin, and dexamethasone in saline was administered via RVP.
  • The drug solution was injected into a dorsal foot vein, followed by a 20-minute arterial blood supply blockade.

Related Experiment Videos

  • Treatment consisted of daily RVP for 7–10 days in 7 patients.

    • Main Results:

    • One patient experienced complete healing of plantar ulcers within four weeks.
    • The remaining six patients showed reduced inflammatory signs and up to 50% reduction in ulcer size.
    • RVP demonstrated improved therapeutic effects compared to conventional systemic infusions.

    Conclusions:

    • Retrograde venous perfusion (RVP) is a promising therapeutic approach for ulcero-mutilating neuropathy.
    • RVP facilitates effective drug delivery to the affected limb, leading to clinical improvement.
    • Further research is warranted to optimize RVP protocols for this condition.