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Kim, Kim, Young, Lee, Hur, and Lee: Treatment of a Chronic Gouty Ulcer on the Lateral Malleolus with Vacuum-Assisted Closure (VAC) Therapy
Case Report
Journal of Rheumatic Diseases

Journal of Rheumatic Diseases 2012; 19(4): 230-233.

Published online: 31 August 2012

DOI: https://doi.org/10.4078/jrd.2012.19.4.230

Treatment of a Chronic Gouty Ulcer on the Lateral Malleolus with Vacuum-Assisted Closure (VAC) Therapy

Yong Hoon Kim1, Jin-Su Kim1, Ki Won Young1, Hong Soup Lee1, Jin Uk Hur2, Kyung Tai Lee3

1Surgery of Foot and Ankle, Eulji Medical Center, Eulji College of Medicine, Eulji University, Seoul, Korea.

2Rheumatism Medicine, Eulji Medical Center, Eulji College of Medicine, Eulji Universty, Seoul, Korea.

3KT Lee's Orthopedic Hospital, Seoul, Korea.

Corresponding to: Jin-Su Kim, Surgery of Foot and Ankle, Eulji Medical Center, Eulji College of Medicine, Eulji University, 14, Hangeulbiseok-gil, Nowon-gu, Seoul 139-711, Korea. jins33@hanmail.net

Received 19 September 2011       Revised 20 October 2011       Accepted 20 October 2011

Copyright © 2012 by The Korean College of Rheumatology

(free-access):

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gouty ulceration is a clinical manifestation of gout, which is a metabolic disease induced by disturbed purine metabolism. In general, protruded gout tophus and secondary infection made a gouty ulceration. It was generally treated with surgical debridement of the tophus and infected tissue. Inevitably, we make the skin defect if needed the wide surgical debridement. We waited for granulation tissue healing of the defect, then finished with a skin graft. However, larger sized gouty ulcerations require a longer period of healing time. We commonly used the vacuum assisted wound closer device (VAC) for shortening the healing time in diabetic foot ulceration. Use of VAC for a gouty ulceration was not nearly reported in literature. We report on the use of VAC after surgical debridement to heal a chronic gouty ulceration around the lateral malleolus.

Keywords: Gout, Ulceration, Vacuum assisted wound closure

Figures and Tables

Figure 1
A 70-years old male patient came to our hospital with chronic infected ulceration at his lateral malleolar area. The ulceration seen in (A) 5×3 cm defect, pus drainage, whitish materials like tophi. We debrided the wound meticulously, and applied a vacuum assisted wound closure device. The tophus was remained in the soft tissue defect after the debridement (B). (C) shows the well granulated wound after 6 weeks. The wound was healed completely after 10 weeks treatment (D).
jrd-19-230-g001

References

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