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Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial

BACKGROUND: Buruli ulcer (BU) is an infection of the subcutaneous tissue leading to chronic necrotizing skin ulcers. The causative pathogen, Mycobacterium ulcerans, grows best at 30°C–33°C and not above 37°C. We explored the safety, tolerability and efficacy of phase change material (PCM), a novel h...

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Autores principales: Junghanss, Thomas, Um Boock, Alphonse, Vogel, Moritz, Schuette, Daniela, Weinlaeder, Helmut, Pluschke, Gerd
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637542/
https://www.ncbi.nlm.nih.gov/pubmed/19221594
http://dx.doi.org/10.1371/journal.pntd.0000380
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author Junghanss, Thomas
Um Boock, Alphonse
Vogel, Moritz
Schuette, Daniela
Weinlaeder, Helmut
Pluschke, Gerd
author_facet Junghanss, Thomas
Um Boock, Alphonse
Vogel, Moritz
Schuette, Daniela
Weinlaeder, Helmut
Pluschke, Gerd
author_sort Junghanss, Thomas
collection PubMed
description BACKGROUND: Buruli ulcer (BU) is an infection of the subcutaneous tissue leading to chronic necrotizing skin ulcers. The causative pathogen, Mycobacterium ulcerans, grows best at 30°C–33°C and not above 37°C. We explored the safety, tolerability and efficacy of phase change material (PCM), a novel heat application system for thermotherapy of BU. METHODOLOGY/PRINCIPAL FINDINGS: In a prospective observational single centre proof-of-principle trial in Ayos/Cameroon, six laboratory reconfirmed patients with ulcerative Buruli lesions received 28–31 (ulcers ≤2 cm) or 50–55 (ulcers >2 cm) days of thermotherapy with the PCM sodium acetate trihydrate as heat application system. This PCM is widely used in commercial pocket heat pads, it is easy to apply, rechargeable in hot water, non-toxic and non-hazardous to the environment. All patients enrolled in the trial completed treatment. Being completely mobile during the well-tolerated heat application, acceptability of the PCM bandages was very high. In patients with smaller ulcers, wounds healed completely without further intervention. Patients with large defects had skin grafting after successful heat treatment. Heat treatment was not associated with marked increases in local inflammation or the development of ectopic lymphoid tissue. One and a half years after completion of treatment, all patients are relapse-free. CONCLUSIONS/SIGNIFICANCE: Our reusable PCM-based heat application device appears perfectly suited to treat BU in endemic countries with limited resources and infrastructure. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN88392614
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spelling pubmed-26375422009-02-17 Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial Junghanss, Thomas Um Boock, Alphonse Vogel, Moritz Schuette, Daniela Weinlaeder, Helmut Pluschke, Gerd PLoS Negl Trop Dis Research Article BACKGROUND: Buruli ulcer (BU) is an infection of the subcutaneous tissue leading to chronic necrotizing skin ulcers. The causative pathogen, Mycobacterium ulcerans, grows best at 30°C–33°C and not above 37°C. We explored the safety, tolerability and efficacy of phase change material (PCM), a novel heat application system for thermotherapy of BU. METHODOLOGY/PRINCIPAL FINDINGS: In a prospective observational single centre proof-of-principle trial in Ayos/Cameroon, six laboratory reconfirmed patients with ulcerative Buruli lesions received 28–31 (ulcers ≤2 cm) or 50–55 (ulcers >2 cm) days of thermotherapy with the PCM sodium acetate trihydrate as heat application system. This PCM is widely used in commercial pocket heat pads, it is easy to apply, rechargeable in hot water, non-toxic and non-hazardous to the environment. All patients enrolled in the trial completed treatment. Being completely mobile during the well-tolerated heat application, acceptability of the PCM bandages was very high. In patients with smaller ulcers, wounds healed completely without further intervention. Patients with large defects had skin grafting after successful heat treatment. Heat treatment was not associated with marked increases in local inflammation or the development of ectopic lymphoid tissue. One and a half years after completion of treatment, all patients are relapse-free. CONCLUSIONS/SIGNIFICANCE: Our reusable PCM-based heat application device appears perfectly suited to treat BU in endemic countries with limited resources and infrastructure. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN88392614 Public Library of Science 2009-02-17 /pmc/articles/PMC2637542/ /pubmed/19221594 http://dx.doi.org/10.1371/journal.pntd.0000380 Text en Junghanss et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Junghanss, Thomas
Um Boock, Alphonse
Vogel, Moritz
Schuette, Daniela
Weinlaeder, Helmut
Pluschke, Gerd
Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title_full Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title_fullStr Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title_full_unstemmed Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title_short Phase Change Material for Thermotherapy of Buruli Ulcer: A Prospective Observational Single Centre Proof-of-Principle Trial
title_sort phase change material for thermotherapy of buruli ulcer: a prospective observational single centre proof-of-principle trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637542/
https://www.ncbi.nlm.nih.gov/pubmed/19221594
http://dx.doi.org/10.1371/journal.pntd.0000380
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