A Case of Full-Body Thermotherapy for Healing a Stump Ulcer in an Elderly Patient with Lower Limb Amputation
Introduction/Background: More than 50% of lower limb amputations in elderly patients are attributed to peripheral circulatory disorders. Conditions such as collagen diseases and autoimmune disorders are significant risk factors for lower limb amputation. Furthermore, post-amputation, there is a heightened risk of developing intractable ulcers in the remaining limb, which can hinder proper prosthetic fitting and the restoration of gait function. Full-body thermotherapy, known as “Waon therapy” improves peripheral circulation. Here, we present a single case in which full-body thermotherapy was applied to a patient with systemic sclerosis and rheumatoid arthritis who underwent a lower limb amputation due to recurrent venous ulcers, ultimately achieving successful gait restoration with a transtibial prosthesis. Case Report: A 70-year-old female patient with a medical history of systemic sclerosis, rheumatoid arthritis, and bilateral lower leg varicose veins experienced worsening cold sensations and pain in the right lower limb starting in early December. She was admitted to our hospital in January of the following year for treatment of a venous ulcer on her right foot. Although bypass surgery was performed on the affected limb, the ulcer progressively worsened, leading to a right lower limb amputation in April of the same year. Following the procedure, the patient was transferred to a convalescent rehabilitation ward for prosthetic training. At the time of transfer to the convalescent rehabilitation ward, an ulcer was already present on the stump end. To improve peripheral circulation, we initiated simple whole-body heat therapy using hot packs and thermal sheets 4 weeks after the transfer. Cold sensation and pain at the stump improved within 1 week of starting this therapy. Over the course of treatment, improved skin perfusion pressure in both legs and epithelialization of the ulcer were observed, ultimately enabling optimal prosthetic fitting of the right lower limb and successful gait acquisition with bilateral Lofstrand crutches. Discussion: In this case, we implemented a simplified full-body thermotherapy for an elderly amputee patient with multiple underlying conditions contributing to peripheral circulatory disorders and achieved favorable outcomes. This therapy is cost-effective, does not require specific facilities, and appears to be applicable in diverse settings.
