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Lidocaine controls pain and allows safe wound bed preparation and debridement of digital ulcers in systemic sclerosis: a retrospective study

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Abstract

In Systemic Sclerosis (SSc), digital ulcers (DU) are painful, difficult to heal, and frequently infected. To reduce the risk of bacterial infection and to prevent chronicity, it is essential to carefully remove necrotic tissue from DU, with maximum patient comfort. Debridement, although very efficacious, is invasive and causes local pain: lidocaine is a local anesthetic commonly used as to fight pain during debridement procedures. The aim of the study was to evaluate the efficacy of lidocaine 4 % in pain control during debridement procedure of DU in SSc. One hundred eight DU characterized by pain Numeric Rating Scale (NRS) >3/10 before starting the procedure were treated with lidocaine 4 % (lidocaine cloridrate 200 mg in 5 ml of injecting solution). Pain was measured with NRS (0–10) before starting debridement, after 15 min of lidocaine application and at the end of the procedure. In DU, in respect to baseline (mean NRS 6.74 ± 2.96), pain after application of lidocaine 4 % for 15 min was significantly lower (mean NRS 2.83 ± 2.73) (p < 0.001). At the end of the procedure, pain control was still maintained and significantly lower (mean NRS 2.88 ± 2.65) in respect to baseline (p < 0.001). No systemic adverse event due to topical lidocaine were observed. In SSc, topical application of lidocaine 4 % significantly reduces pain, allowing a safe debridement procedure, thus improving the management of DU.

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Authors and Affiliations

  1. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Francesca Braschi, Francesca Bartoli, Cosimo Bruni, Ginevra Fiori, Claudia Fantauzzo, Lucia Paganelli & M. Matucci-Cerinic

  2. Department of Geriatric Medicine Division of Rheumatology AOUC, University of Florence, Florence, Italy

    Francesca Braschi, Francesca Bartoli, Cosimo Bruni, Ginevra Fiori, Claudia Fantauzzo, Lucia Paganelli & M. Matucci-Cerinic

  3. Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy

    Amato De Paulis

  4. Department of Public Health AOUC, University of Florence, Florence, Italy

    Laura Rasero

Authors
  1. Francesca Braschi
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  2. Francesca Bartoli
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  3. Cosimo Bruni
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  4. Ginevra Fiori
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  5. Claudia Fantauzzo
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  6. Lucia Paganelli
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  7. Amato De Paulis
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  8. Laura Rasero
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  9. M. Matucci-Cerinic
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Corresponding author

Correspondence to Francesca Bartoli.

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Informed consent was obtained from all patients prior the procedure and the study was approved by our local ethical committee.

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Additional information

F. Braschi and Francesca Bartoli have contributed equally to this work

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Braschi, F., Bartoli, F., Bruni, C. et al. Lidocaine controls pain and allows safe wound bed preparation and debridement of digital ulcers in systemic sclerosis: a retrospective study. Clin Rheumatol 36, 209–212 (2017). https://doi.org/10.1007/s10067-016-3414-7

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  • DOI: https://doi.org/10.1007/s10067-016-3414-7

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