Abstract
BackgroundRecurrent chronic leg ulcers and its are morbidities associated with sickle cell anaemia (SCA). Compression therapy increases the rate of healing of these ulcers and also decreases the rate of recurrence.ObjectiveThis study evaluated the haematological parameters of patients with SCA and chronic leg ulcers placed on high compression bandaging to provide data for improved ulcer management and prevention.MethodsEighteen patients with SCA and chronic leg ulcers were recruited for treatment by compression therapy in Ibadan, Nigeria, from March to June 2015. Eighteen SCA patients with no history of chronic leg ulcers were age and sex matched and recruited as controls. Blood samples, wound biopsies and swabs were collected at different time points for full blood count, microbiology, culture and antimicrobial susceptibility tests. Haemoglobin variants were quantified by high performance liquid chromatography. Fasting blood sugar was tested for leg ulcer patients to determine diabetic status.ResultsUlcers ranged from 0.5 cm2 to 416 cm2 (median: 38.4 cm2). Post-intervention ulcer size ranged from 0.0 cm2 to 272 cm2 (median: 18.6 cm2, p < 0.001); four ulcers completely healed. Compared to the control group, haematological indices at commencement of treatment were more severe in leg ulcer patients (p = 0.02). No patients with chronic leg ulcer was diabetic. Microorganisms isolated from the leg ulcers include Pseudomonas aeruginosa, Staphylococcus aureus, Proteus sp., Escherichia coli and Klebsiella oxytoca.ConclusionMeasures to improve haematological parameters during leg ulcer treatment in SCA patients should be taken to aid wound healing.
Highlights
Chronic leg ulcer is one of the morbidities associated with sickle cell anaemia (SCA)
In SCA patients, the polymerisation of haemoglobin S (HbS) leads to the formation of sickled red blood cells (RBCs) which become trapped in the microcirculatory system
Within the 3 months of compression therapy, four of the patients had complete close-up of the ulcer wound, 16 of them had more than a 50% healing rate and the remaining five had a healing rate of 35% – 50%
Summary
Chronic leg ulcer is one of the morbidities associated with sickle cell anaemia (SCA). Chronic leg ulcer is a wound on the skin that occurs between the knee and the foot, showing no signs of healing after 3 months of proper treatment.[1] In SCA patients, the polymerisation of haemoglobin S (HbS) leads to the formation of sickled red blood cells (RBCs) which become trapped in the microcirculatory system. This leads to microvascular vaso-occlusion causing tissue ischaemia and associated pain. Compression therapy increases the rate of healing of these ulcers and decreases the rate of recurrence
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