2023 Volume 30 Issue 10 Pages 227-231
Case: A 59-year-old woman. Venous stasis ulcer starting from small ulcers on the right first and second toes. Despite treatments such as varicose vein surgery and skin grafting, the ulcer enlarged. She was referred to our department for treatment of wound related pain. Symptoms: Extensive ulcers were found in the lower third of both lower legs. Hyperalgesia and allodynia were observed in the ulcer and its surroundings. By placing epidural catheter with subcutaneous injection port (epidural port), it was possible to wash the ulcer area and remove defective tissue under analgesia, and allodynia was improved by using spinal cord stimulation (SCS). More than 5 years have passed since the start of pain treatment with epidural port and SCS, but no infection or functional problems have been observed. Summary: The combination of epidural port and SCS was effective for long-term analgesic management of chronic venous ulcers. Complications such as infection and epidural fibrosis require regular scrutiny and preparation.
