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A treatment algorithm to identify therapeutic approaches for leg ulcers in patients with sickle cell disease

Igor A Altman1, Raymond E Kleinfelder2, John G Quigley3

  • 1Department of Surgery, Section of Wound Healing and Tissue Repair, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.

International Wound Journal
|November 6, 2015
PubMed

Insights

Sickle cell leg ulcers (SCLUs), a common complication of sickle cell disease (SCD), indicate severe vasculopathy. This summary covers SCLU pathophysiology, treatments, and a proposed algorithm for managing these challenging ulcers.

Area of Science:

  • Hematology
  • Vascular Medicine
  • Wound Healing

Background:

  • Sickle cell leg ulcers (SCLUs) are a frequent and debilitating complication of sickle cell disease (SCD).
  • Patients with SCLUs often exhibit more severe hemolytic-associated vasculopathy and other SCD complications like priapism and pulmonary hypertension.
  • These ulcers are characterized by slow healing and high recurrence rates, significantly impacting patient quality of life.

Purpose of the Study:

  • To summarize the current understanding of the pathophysiology of sickle cell leg ulcers.
  • To review and describe the available treatment options for SCLUs.
  • To propose a treatment algorithm for the management of SCLUs.

Main Methods:

  • Literature review on SCLU pathophysiology.
  • Analysis of current therapeutic strategies for SCLUs.
  • Development of a clinical management algorithm based on evidence.

Main Results:

  • SCLUs are linked to severe hemolytic-associated vasculopathy in sickle cell disease patients.
  • Existing treatments for SCLUs have variable success rates and recurrence is common.
  • A structured treatment algorithm can aid in the management of these complex wounds.

Conclusions:

  • Understanding SCLU pathophysiology is crucial for effective treatment.
  • A standardized approach to treatment may improve healing outcomes and reduce recurrence.
  • Further research is needed to optimize SCLU management strategies.

Keywords:
PathophysiologySickle cell leg ulcersSickle cell woundsTreatment algorithm

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