SUCCESSFUL TREATMENT USING NEGATIVE-PRESSURE THERAPY FOR DEEP DISSECTING HEMATOMA DUE TO DERMATOPOROSIS

摘要

The present case is that of an 84-year-old woman who had been using dabigatran (Prazaxa? Boehringer Ingelheim, Germany) for 6 months to prevent recurrence of a cerebral infarction. Two days before initial examination at our hospital, she sustained a bruise on her right lower leg, followed by gradual exacerbation of subcutaneous bleeding and partial swelling. She was therefore referred to our hospital for examination. Although computed tomographic imaging of the site revealed a subcutaneous hematoma, no clear hematoma was observed in the muscle layer. Based on these findings, she was diagnosed with deep dissecting hematoma. After removing the hematoma through a skin incision, we performed negative-pressure therapy (NPT) with the application of a basic fibroblast growth factor spray. Granulation tissue gradually formed. NPT was continued following a subsequent skin grafting. NPT has previously been performed as a treatment for skin ulcers and engraftment of skin. Currently, NPT allows for more certain and stable application of negative pressure, which has led to relatively short healing times.