Nobuyuki Arai, MD, Hiromichi Metani, MD, Rina Abe, MD, Sayako Shimizu, MD,
Sosuke Seki, MD, Takasi Hiraoka, MD, Kozo Hanayama, MD, Akio Tsubahara, MD
Jpn J Compr Rehabil Sci 5: 61-65, 2014
This report describes the case of an elderly amputee (lower leg) with obstructive arteriosclerosis, diabetes, angina (post CABG), and intractable ulcers on the non-amputated leg. The patient received full-body thermotherapy using heat packs and thermal sheeting and was subsequently able to walk. Despite drug therapy to improve peripheral circulation in addition to meticulous foot care, ulcers on the foot of the nonamputated side worsened. After full-body thermotherapy, however, skin perfusion pressure improved, and the ulcers gradually healed. The patient was discharged home, at which time the combined use of Lofstrand crutches, a prosthesis, and a footplate for pressure relief enabled outdoor walking for short distances. Patients with skin lesions who undergo amputation as a consequence of peripheral circulation disorders often have difficulty walking with a prosthetic limb. Moreover, the full-body thermotherapy provided similar effectiveness to the Waon dry sauna therapy, which is available only at a limited number of institutions. This thermotherapy is a promising supplemental therapy for elderly amputees with circulatory disorders, and could easily be provided by many institutions.
Key words: elderly, amputation, obstructive arteriosclerosis, diabetic foot lesions, thermotherapy