{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T21:12:54Z","timestamp":1754601174927,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hautarzt"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Bei einer 59-j\u00e4hrigen adip\u00f6sen Patientin bestand seit 1986 ein schmerzhaftes, chronisches Ulcus cruris. Wir stellten die Diagnose eines Ulcus cruris venosum bei funktioneller chronischer ven\u00f6ser Insuffizienz im Rahmen der Adipositas per magna (Dependency-Syndrom) und arthrogenem Stauungssyndrom bei Immobilit\u00e4t. Obwohl in der Vergangenheit bereits eine Krossektomie und Stripping der V.\u00a0saphena magna und mehrfach eine Shave-Therapie mit Spalthauttransplantation nach entsprechender Wundgrundkonditionierung erfolgten, persistierte die Wunde. Bei therapierefrakt\u00e4rem Verlauf und hohem Leidensdruck mit ausgepr\u00e4gten Schmerzen war es 2012 der Wunsch der Patientin, das Bein zu amputieren. Als Alternative zu der Amputation f\u00fchrten wir eine krurale Fasziektomie durch und nach erfolgter Wundgrundkonditionierung mittels 2\u00a0Zyklen einer Vakuumtherapie eine anschlie\u00dfende Versorgung des Defektes mit einer Spalthaut in Mesh-graft-Technik. Die Operation verlief ohne Komplikationen, und die Haut heilte vollst\u00e4ndig ein. Bei der aktuellen Wiedervorstellung 7\u00a0Jahre nach dem Eingriff zeigte sich trotz weiterhin bestehender Adipositas per magna und Immobilit\u00e4t eine vollst\u00e4ndige Heilung des zuvor therapierefrakt\u00e4ren Ulcus cruris venosum. Dieser Fallbericht zeigt eindrucksvoll, dass insbesondere bei ansonsten therapierefrakt\u00e4ren Verl\u00e4ufen des Ulcus cruris venosum eine krurale Fasziektomie erwogen werden kann.<\/jats:p>","DOI":"10.1007\/s00105-020-04659-3","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T19:03:24Z","timestamp":1595876604000},"page":"157-162","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Langfristige Abheilung eines therapierefrakt\u00e4ren Ulcus cruris venosum nach kruraler Fasziektomie und Spalthauttransplantation","Long-term healing of a\u00a0therapy-refractory venous leg ulcer after crural fasciectomy and split skin graft transplantation"],"prefix":"10.1007","volume":"72","author":[{"given":"Monika","family":"Kleinhans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Stoffels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Dissemond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"4659_CR1","first-page":"2018","volume":"22","author":"K Garzon","year":"2010","unstructured":"Garzon\u00a0K, Obermayer\u00a0A, Hirschl\u00a0M (2010) Das adipositasassoziierte Dependency Syndrom. Vasomed 22:2018","journal-title":"Vasomed"},{"key":"4659_CR2","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1055\/s-0037-1622262","volume":"38","author":"K G\u00f6stl","year":"2009","unstructured":"G\u00f6stl\u00a0K, Obermayer\u00a0A, Hirschl\u00a0M (2009) Pathogenesis of chronic venous insufficiency by obesity. Phlebologie 38:108\u2013113","journal-title":"Phlebologie"},{"key":"4659_CR3","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1111\/j.1610-0387.2007.06599.x","volume":"5","author":"C Grattenthaler","year":"2007","unstructured":"Grattenthaler\u00a0C, Thoms\u00a0KM, Kretschmer\u00a0L (2007) Paratibiale Fasziotomie beim Ulcus cruris postthromboticum mit dem Fasziotom nach Vollmar. J\u00a0Dtsch Dermatol Ges 5:1144\u20131145","journal-title":"J Dtsch Dermatol Ges"},{"key":"4659_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/s-0037-1617337","volume":"29","author":"W Hach","year":"2000","unstructured":"Hach\u00a0W (2000) Chronische ven\u00f6se Kompartmentsyndrome. Phlebologie 29:1\u201326","journal-title":"Phlebologie"},{"key":"4659_CR5","first-page":"109","volume":"12","author":"W Hach","year":"1983","unstructured":"Hach\u00a0W, Langer\u00a0C, Schirmers\u00a0U (1983) Das arthrogene Stauungssyndrom. Vasa 12:109\u2013116","journal-title":"Vasa"},{"key":"4659_CR6","first-page":"1616","volume":"36","author":"W Hach","year":"1985","unstructured":"Hach\u00a0W, Vanderpuye\u00a0R (1985) Operationstechnik der paratibialen Fasziotomie. Medwelt 36:1616\u20131618","journal-title":"Medwelt"},{"key":"4659_CR7","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1111\/iwj.12387","volume":"13","author":"F Jockenh\u00f6fer","year":"2016","unstructured":"Jockenh\u00f6fer\u00a0F, Gollnick\u00a0H, Herberger\u00a0K, Isbary\u00a0G, Renner\u00a0R, St\u00fccker\u00a0M, Valesky\u00a0E, Wollina\u00a0U, Weichenthal\u00a0M, Karrer\u00a0S, Kuepper\u00a0B, Roesch\u00a0A, Dissemond\u00a0J (2016) Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1000 patients from 10 specialised dermatological wound care centers in Germany. Int Wound\u00a0J 13:821\u2013828","journal-title":"Int Wound J"},{"key":"4659_CR8","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1067\/mva.2003.61","volume":"37","author":"F Padberg","year":"2003","unstructured":"Padberg\u00a0F, Cerveira\u00a0JJ, Lal\u00a0BK, Pappas\u00a0PJ, Varma\u00a0S, Hobson\u00a0RW (2003) Does severe venous insufficiency have a\u00a0different etiology in the morbidly obese? Is it venous? J\u00a0Vasc Surg 37:79\u201386","journal-title":"J Vasc Surg"},{"key":"4659_CR9","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1007\/s001050050488","volume":"47","author":"W Schmeller","year":"1996","unstructured":"Schmeller\u00a0W, Roszinski\u00a0S (1996) Shave-Therapie zur operativen Behandlung persistierender ven\u00f6ser Ulzera mit gro\u00dffl\u00e4chiger Dermatoliposklerose. Hautarzt 47:676\u2013681","journal-title":"Hautarzt"},{"key":"4659_CR10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1055\/s-0037-1622134","volume":"35","author":"W Schmeller","year":"2006","unstructured":"Schmeller\u00a0W, Schwahn-Schreiber\u00a0C, Gaber\u00a0Y (2006) Langzeitergebnisse nach Shave-Therapie bzw. kruraler Fasziektomie bei persistierenden ven\u00f6sen Ulzera. Phebologie 35:89\u201391","journal-title":"Phebologie"}],"container-title":["Der Hautarzt"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00105-020-04659-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00105-020-04659-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00105-020-04659-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T23:05:35Z","timestamp":1627340735000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00105-020-04659-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,27]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["4659"],"URL":"https:\/\/doi.org\/10.1007\/s00105-020-04659-3","relation":{},"ISSN":["0017-8470","1432-1173"],"issn-type":[{"type":"print","value":"0017-8470"},{"type":"electronic","value":"1432-1173"}],"subject":[],"published":{"date-parts":[[2020,7,27]]},"assertion":[{"value":"27 July 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"M.\u00a0Kleinhans, I.\u00a0Stoffels und J.\u00a0Dissemond geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. F\u00fcr Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, \u00fcber die Patienten zu identifizieren sind, liegt von ihnen und\/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}