Treatment of Ischial Pressure Sores by Means of Sclerotherapy Using Absolute Ethanol

Abstract

The ischial region is a common site of pressure sore. The ischial pressure sore with a large subcutaneous bursa is resistant to conservative treatment and tends to require radical surgical treatment. In this article the authors describe their experience with a simple surgical treatment on 8 ischial pressure sores in 7 patients with subcutaneous bursa by means of sclerotherapy using absolute ethanol. This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. This alternative method has a possibility of treating pressure sores as well as other fistulous diseases in various areas.

Cranial dermoid cyst with long-term development treated by ethanol sclerotherapy: a case report

“…Ethanol causes inflammatory reactions involving endothelial cells of the cyst wall, leading to fibrosis and cyst closure. Sclerotherapy using absolute ethanol has the benefit of technical simplicity and low cost compared to other sclerosants [10].…”

Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

“…It has recently been used for the treatment of chronic recurrent ischial pressure sores following surgical treatment [14] and rheumatoid bursal cysts [15]. Absolute ethanol causes damage to the endothelial cells in abnormal vessels, sterilizes the environment by its bactericidal effect, and alters the subcutaneous layer by coagulation as well as tissue modification of cell proteins.…”

“…Sclerotherapy using ethanol has been widely used in the treatment of esophageal piles, vascular malformations, varicose veins, and benign cysts, such as thyroglossal cysts, renal cysts, and ovarian endometriomas. It has recently been used for the treatment of chronic recurrent ischial pressure sores following surgical treatment [ 14 ] and rheumatoid bursal cysts [ 15 ]. Absolute ethanol causes damage to the endothelial cells in abnormal vessels, sterilizes the environment by its bactericidal effect, and alters the subcutaneous layer by coagulation as well as tissue modification of cell proteins.…”

“…Since absolute ethanol causes tissue conglutination and obliteration of the dead space, it has been widely used to treat cavitary disease. Systemic side effects are rare unless absolute ethanol is directly injected into blood vessels [ 14 ]. Absolute ethanol has rarely been reported as a cause of hypersensitivity.…”

Ischial and Sacral Pressure Ulcers

“…Several flap coverage methods have been reported for treating ischial pressure ulcers. Sclerotherapy is an alternative method that can be used when a large bursa forms under the skin in patients with a small skin defect that can be closed directly 15) . This method is simpler and less invasive than flap surgery; however, it cannot be used in patients with inflammation or exposed bone.…”