<b>Three Hemodialysis Patients with Postoperative Amputation Wounds Due to Critical Limb Ischemia Successfully Treated with Juzentaihoto and </b><b>Keishibukuryogan</b> / 日本東洋医学雑誌

ABSTRACT

<p>Peripheral arterial disease is a serious complication that can arise in hemodialysis patients. Prognosis in critical limb ischemia (CLI) due to peripheral arterial disease is extremely poor. A dialysis patient may experience symptoms of both <i>qi </i>and <i>ketsu </i>deficiency and <i>ketsu </i>stagnation during the long-term treatment of CLI. Herein, we report three hemodialysis patients with refractory postoperative skin ulcers who were successfully treated with juzentaihoto and keishibukuryogan after limb amputation. Case 1 was a 68-year-old man who had skin ulcers of the right second, third, and fifth toes. After amputation of the third toe, juzentaihoto and keishibukuryogan were initiated. Case 2 was a 67-year-old man who had skin ulcers after amputation of the left fourth and fifth toes. Postoperatively, juzentaihoto and keishibukuryogan were initiated, and good granulation was observed. Case 3 was a 76-year-old man who had skin ulcers after left below-the-knee amputation. Because of the extremely poor tissue granulation, juzentaihoto and keishibukuryogan were initiated, and good granulation was gradually observed. After an operation for CLI, prompt return to activities of daily living is desirable. The appropriate addition of Kampo treatment to Western treatment may improve chronic refractory skin ulcers.</p>