Thermotherapy of Buruli Ulcer

The temperature sensitivity of M. ulcerans has long been recognized. Meyers et al. in the 1970ies successfully treated patients with local heat application. Based on this success, WHO guidelines listed the application of heat as a treatment option for BU in 2000. However, the heat application devices initially employed were impractical. The phase change material (PCM) sodium acetate trihydrate, offers an ideal technical solution. Both, a proof-of-principle and a phase II trial showed that thermotherapy with rechargeable heat packs filled with sodium acetate is well tolerated and effective. Heat packs can be applied in early, undifferentiated stages of disease without causing harm and with the benefit of preventing advancement into severe complicated disease. Thermotherapy is highly effective, easy to apply, cheap, well tolerated, free of relevant adverse effects and has nonspecific positive effects on wound healing.