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Case Report: Topical Gel for the Treatment of a Refractory Leg Ulcer

Author(s):  Israel Alan

Issue:  May/Jun 2003 - Diabetes and Wound Care
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Abstract:  This case report describes the effect of a topical gel used to treat a large ulcer that had been refractory to cure for 2 years. The patient, a 55-year-old man, had fractured all the bones in his left foot and ankle in a fall; and lymphedema and a large ulcer had subsequently developed. Although he was treated over the next 2 years, the wounds did not heal. Implantation of a pump to relieve the lymphedema was unsuccessful, and the skin around the ulcer began to split. When the swollen surrounding area was lanced, the ulcer increased in size and surrounding skin split. The patient had been treated only with oral morphine sulfate for 1 month after surgery to relieve pain and oral warfarin sodium. The patient then underwent a 21-day cycle of debriding and massage and was prescribed two preparations: one was a gel base containing misoprostol 0.0024%, phenytoin 1%, metronidazole 2% and lidocaine 2%; the other was nifedipine 16% in a gel base. These were applied topically as treatment for 42 days, at which time the ulcer was 95% healed.

Related Keywords: Ulcer, treatment of, Wound gel, topical, for treatment of leg ulcer


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