Combined therapy with prostaglandin E1 ointment and lumbar sympathetic ganglion block on intractable skin ulcers accompanied by Bürger's disease]

For the 2 patients with intractable skin ulcers and pain accompanied by thromboangiitis obliterans (Bürger's disease), we applied combined therapy with lumbar sympathetic block, continuous epidural block and prostaglandin E1 ointment. Prostaglandin E1 (PGE1) was prepared as a topical ointment by mixing with Plastibase (polyethylene resin, 5%, liquid paraffin, 95%) at a concentration of 10 micrograms.g-1. The ointment was kept in a refrigerator until use. Following debridement and washing of the surface of ulcers as required, the ointment was applied evenly onto the surrounding and over the surface of each ulcer 2 times daily after sterilization. With this therapy the ulcers were cured completely in 10 days after the start of treatment. No side effect was observed both locally and systemically. Although the combined therapy we used with prostaglandin E1 ointment was a noninvasive method, a remarkable shortening of the period of treatment was achieved.