Martorell ulcer: chronic wound management and rehabilitation

Figures & data

Figure 1 Martorell HYTILU on the dorsolateral leg. A shallow, well-demarcated ulceration with a violaceous border and areas of necrosis.

Table 1 Summary of interventions for martorell hypertensive ischemic leg ulcer

Study	Methodology	Sample size	Interventions	Summary of findings
Hafner et al 2010^Citation4	Retrospective case series	31 patients (47 ulcers)	Autologous split-thickness grafting: 26 patients	28 patients fully recovered: 26 patients received autologous spit-thickness grafting, 2 received conservative management. 3 patients died due to sepsis
			Conservative management: 2 patients
Henderson et al 1995^Citation11	Retrospective case series	16 patients (22 ulcers)	Conservative management: 6 patients	20/22 (91%) of ulcers healed. 2/22 (9%) legs had to undergo amputation
			Sympathetic ablation: 2 patients
			Excision and grafting: 6 patients
			Excision, grafting, and sympathetic ablation: 4 patients
Leloup et al 2015^Citation19	Retrospective case series	17 Martorell HYTILU patients	Electrostimulation	Significant reduction in pain scores in 7–9 days (average pain scores reduced from 6.9 to 2.8) and in number of analgesic treatments used
Dagregorio and Guillet 2006^Citation3	Retrospective case series	15 patients (20 ulcers)	Mesh skin grafting	13/15 (87%) fully recovered and the other 2 were lost to follow-up. The average healing time was 14 days
Pacifico et al 2011^Citation22	Prospective cohort study	10 patients	Prostaglandin El (PGEI) therapy with antihypertensives	All patients healed but there was a significantly reduced healing time in those that received PGEI therapy. The average healing time with those receiving PGEI therapy was 41.7 days, compared to 98.5 days in those who did not
Obermayer et al 2016^Citation15	Retrospective case series	9 Martorell HYTILU patients	Lateral fasciectomy with simultaneous mesh skin grafting	All ulcers healed within 1 year
Malhi et al 2017^Citation12	Case report	1 patient	Radical debridement, negative-pressure wound therapy, and split-thickness skin grafting.	The ulcer completely healed
Pinto et al 2015^Citation13	Case report	1 patient	Anti-hypertensive therapy, surgical debridement, and petrolatum dressings.	The ulcer healed
Conde Montero et al 2018^Citation14	Case report	1 patient	Punch skin grafting, anticoagulati on replaced by heparin.	The ulcer healed after 4 weeks
De Andres et al 2011^Citation20	Case report	1 patient	Spinal cord stimulation	Complete resolution of the ulcer was achieved in 12 weeks

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