Radial extracorporeal shock wave therapy in a patient with decubitus ulcer after spinal cord injury: a case report

Decubitus ulcer is a common complication in patients with spinal cord injury (SCI) that can be very difficult to treat. We report a case of a 51-year-old man with a right-heel decubitus ulcer after SCI. The ulcer initially covered an area of 4.8 cm x 4.5 cm and had a depth of 2 cm with denervation and hypoproteinemia. After surgical debridement of the wound, the patient received radial extracorporeal shock wave therapy (rESWT) as an alternative to skin flap transplantation to promote wound healing. The rESWT was administered at 10 Hz once or twice per week for 3 months, first from an R15 transmitter and later from a deep transmitter, with an increasing dosage of 2.0-3.5 bar given in 3000-6000 pulses. After 3 months of rESWT, the ulcer was completely healed. This case report demonstrates that rESWT can be an effective treatment option for patients with decubitus ulcers.