Successful Treatment of Venous Stasis Ulcers with Combination Compression Therapy and Pulsed Radio Frequency Energy in a Patient Scheduled for Amputation

Summary A 78-year old diabetic male with a prior amputation was scheduled for amputation of his remaining leg due to recalcitrant, long term venous stasis ulcers.  Treatment with Pulsed Radio Frequency Energy (PRFE) in concert with compression therapy lead to rapid pain reduction and complete healing of the wounds in 14 weeks.

Background

Venous ulcerations of the distal lower extremity are a common complication of peripheral vascular disease, and are often recurrent and difficult to heal.  Venous ulcers are frequently very painful, and when unresponsive to therapy, may lead to limb amputation

PRFE is a novel biophysical therapy that has been recently applied to venous ulcers.  PRFE uses non-thermal, non-ionizing radio frequency energy to generate an electromagnetic field that has been shown to reduce pain and edema, and promote wound healing. 

Case

A 78-year old man with  diabetes, peripheral neuropathy, peripheral arterial disease, presented complaining of pain (rated 9 out of 10) and a 3-month history of multiple persistant painful venous stasis ulcers, each >5 cm² in surface area, on his left foreleg.  The patient had a right above-the-knee amputation 3 years before for treatment of similar venous ulcers.  The patient was not a candidate for revascularization, and an above-the-knee amputation was recommended.  Faint pedal pulses were audible with doppler assessment;  ABI was 0.61.

In lieu of amputation the patient was begun on compression therapy, topical antimicrobials and PRFE twice daily (30 minute sessions).

Results

Pain diminished rapidly to a score of 1 out of 10 within 7 weeks of treatment. Within 14 weeks, the wounds were completely healed.

Discussion

We describe the reduction in pain and healing of venous stasis ulcers in a diabetic when compression therapy was combined with pulsed radio frequency energy.  Amputation was avoided. This intriguing approach warrants further study and evaluation.