Abstract
The therapy concept of topical factor XIII application was developed on the basis
of clinical and experimental investigations on improvement of wound healing, as well
as on the morphological and pathophysiological topical site of venous ulcers. Topical
treatment with factor XIII is special with regard to mode of application as well as
efficacy, since a lot of other medications used for local wound treatment contain
a fibrinolytic component.
In the last 32 months, 23 inpatients (17 female, 6 male) averaging 62.9 ± 14.1 years
and suffering ulcerative leg disease were treated with topically applied factor XIII.
The average period of distal venous ulcer in these patients was 3.3 ± 2.04 years.
The extent of the ulcer surface ranged between 2.5 × 3.0 cm (minimum) and 18.5 × 8.0
cm (maximum). All patients had been in medical consultation for several years. The
venous ulcers were based upon a “postthrombotic syndrome” in 15 patients. Six patients
were suffering from ulcerations due to arterial and venous mixed disease, and there
were 2 patients with ulcerations of unknown etiology. In 5 patients, 2 with unknown
etiology and 3 with arterial and venous mixed disease, local treatment with factor
XIII was discontinued after 4 weeks because there was definitely no improvement in
wound healing. Additionally, 3 patients with ulcerations due to arterial and venous
mixed disease were treated for a maximum of 6 weeks with only moderate improvement
in healing. Twelve of the 15 patients (79.3%) with extended, chronic ulceration on
the basis of a postthrombotic syndrome showed such a distinct improvement of topical
site after an average of only 3.15 ± 1.14 weeks that they were released for further
ambulatory treatment. Three patients had to be treated for a maximum period of 6 weeks,
also with distinct improvement in wound healing. Apart from a wound surface reduction
and a clinically documentable improvement of granulation tendency, there was a marked
reduction of secretion and bleeding tendency within the ulcer area observed in all
patients. None of the patients showed any systemic or local allergic reactions.
Key words:
Topical application - postthrombotic syndrome - granulation - epithelialization -
secretion
