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Oral Abstracts (Session 5 of 5)
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(Presentation 36.5) Using L-arginine to reduce pain and heal ulcers in patients with nonreconstructable vascular disease Dennis Weiland, MD, Scottsdale Healthcare, Scottsdale, Ariz Problem: Patients with diabetic or ischemic ulcers will not heal their ulcers unless there is an adequate supply of oxygen. Moreover, these patients will often have severe leg pain unless arterial reconstruction can be performed. Many of these patients have arteries that cannot be reconstructed or bypassed, and they are sentenced to persistent discomfort. L-arginine is well known to produce vasodilatation by the release of the potent dilator, nitric oxide. Therefore, with oral administration of the semi-essential amino acid, L-arginine, vasodilatation might occur and increase the supply of oxygen to the ischemic, painful tissues. Methods: Four patients were given Arginaid (contains 4.5 g of L-arginine) twice daily for 2 weeks. Two patients could take only 4.5 g daily because of azotemia and gastrointestinal intolerance. Wounds were clinically assessed weekly and photos of the wounds were taken. Results: Each of these patients showed improvement or healing of the ulcer, reduction of pain, or both. The azotemic patient showed no worsening of the azotemia. One patient showed rapid healing of the ulcer and was able to walk without the assistance of a cane after 1 week of therapy. Conclusions: Patients with diabetes and patients with severe peripheral vascular disease have limited therapeutic options if their vascular disease cannot be reconstructed. Moreover, persistent ulceration proves to be nidus or entry side for infection. In this small series of patients, superficial ulcerations heal and pain is lessened or disappears with the use of oral L-arginine. |
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