The Role of Complex Treatment in Mixed Leg Ulcers – A Case Report of Vascular, Surgical and Physical Therapy

BACKGROUND: Leg ulcers are a burden to patients, their families and society. The second most common cause of chronic leg ulcers is the mixed arterio-venous type. An 80-year-old female patient presented to our department due to painful enlarging chronic leg ulcer of mixed arteriovenous origin on her left lower leg. She suffered from peripheral arterial occlusive disease stage I and chronic venous insufficiency Widmer grade IIIa, and a number of comorbidities.AIM: The aim of our ulcer treatment was a complete and stable wound closure that was hampered by arterial occlusion, exposed tendon, and renal insiffuciency.CASE REPORT: To improve the prognosis for ulcer surgery, we performed percutaneous transluminal angioplasty, transcutaneous CO2 and deep ulcer shaving. The wound was closed by sandwich transplantation using elastin-collagen dermal template and meshed split skin graft. She had a 100% graft take with rapid reduction of severe wound pain.CONCLUSION: Complex approaches are necessary, to gain optimum results in leg ulcer therapy in mixed leg ulcers. Therapeutic nihilism should be abandonend

Sector collapse kinematics and tsunami implications - SEKT, Cruise No. M154/1, April 3 - April 25, 2019, Mindelo (Cape Verde) - Point-á-Pitre (Guadeloupe)

Summary Deep-seated collapses of volcanic islands have generated the largest volume mass flows worldwide. These mass flows might trigger mega-tsunamis. The way in which these collapse events are emplaced is poorly understood, even though this emplacement process determines the scale of associated tsunamis. Key questions such as whether they are emplaced in single or multiple events, how they may incorporate seafloor sediment to increase their volume, and how they are related to volcanic eruption cycles and migration of volcanic centers, remain to be answered. This project forms a part of the comprehensive study of large volcanic island landslide deposits and is directly linked to IODP drilling campaign in the Lesser Antilles (IODP Leg 340). Unfortunately, Leg 340 only recovered material from a single site within the volcanic landslide deposits off Montserrat, and even at this site, recovery was not continuous. This single IODP site is insufficient to document lateral variation in landslide character, which is critical for understanding how it was emplaced. The main scientific goals of this project are to determine where the landslides are sourced from; to understand how these landslides are emplaced; and to understand the relationship between landslides, eruption cycles and initiation of new volcanic centres. Combining 3D seismology (Leg 1) and MeBo cores (Leg 2) provides a unique dataset of the internal structure, composition and source of material throughout a volcanic island landslide. The results will significantly contribute to understanding the emplacement of volcanic island landslides and they will allow us to assess the associated tsunami risk

Exploring subsurface fluid flow and active dewatering along the oceanic plate boundary between Africa and Eurasia (Gloria Fault)

R/V Meteor cruise M162 was conducted as a systematic continuation of ongoing work dedicated to understand if and howfluid flow through crust and sedimentscontinues along transform-type plate boundaries and fracture zones away from mid-ocean ridges and continental margins. Central target was the Gloria Fault in the central Northeast Atlantic. Previous findings along the eastern continuation of the Gloria Fault revealed fault-controlled fluid advection and mud volcanism along strike-slip faults in the Horseshoe Abyssal Plain and the Gulf of Cadiz, where fluid geochemistry revealed the admixture of fluids from deeply buried oceanic crust and oldest sediments on top of it. TheGloria Fault itselfis an old, reactivated, and seismically active oceanic fracture zone. During M162 a systematic survey along the main trace of the Gloria Fault between the Azores Plateau and the Madeira-Tore Rise was carried out, including sub-bottom profiler surveys, heat flow transects, gravity corer sampling, as well as video-guided CTD and multicorer deployments. In accordance to recently recorded seismic activity along the fault, there isevidence for tectonic motion both in sub-bottom profiler records and sediment cores. Heat flow measurements revealed values significantly elevated above the background in many places, predominantly along the main fault trace and other active faults.Ina number of placesfluid geochemistry revealed enhanced diagenetic processes in the sediments, implying the potential relation to upward-directed fluid flow. In summary, cruise M162revealed the first complementary data set on heat flow and fluid geochemistry along an oceanic fault zone, which will further our understanding on themes like the alteration of oceanic lithosphere and crust-ocean element exchange