Wound care for Henry VIII

When we think of Henry VIII, most of us envision an oversized man with multiple wives, a bitter personality and a propensity for beheading his enemies. A lesser-known fact is that he suffered with chronic leg sores the last twenty years of his life. Living in a time before antibiotics, anesthesia and proper wound care, this king endured excruciating ulcers with no cure available. Would history have been different if his sores could have been treated with today's advanced wound care?

As a young man, Henry was athletic and active. Unfortunately, he had multiple sports injuries and one, which occurred in January 1536, seemed to initiate chronic wounds. He was thrown off his horse at a jousting tournament and his fully armored horse landed on top of him. Reports from the time state he was unconscious for two hours and had several leg bone fractures. Initially, he appeared to heal, but he later developed ulcers in his legs, and historians note, at that point, his personality changed.

His doctors lanced and drained his ulcers, but they never fully healed. There is much modern speculation as to what caused his sores. Likely the injury was the source, but his love of wearing garters around his calves also likely increased his risk for developing varicose veins and blood clots in his legs. His activity level dropped due to his pain and his weight increased. He was at increased risk for type 2 diabetes, high blood pressure and high cholesterol. All these things together made him susceptible to leg ulcers from blood vessels that did not work well, making it difficult for his initial wounds to heal.

If I were transported back to Henry's court with the limited medical knowledge of that time, there would be little I could do to help him. However, if we were to transport Henry to modern day, we would observe his veins and arteries with ultrasounds. We'd use CT scans to see if infection had gone into the bone. We could determine his ankle-brachial index indicating how well his blood is flowing. And Henry would be given anesthesia while we probed and debrided the wounds. We could treat the root of the infection with antibiotics. And, devices such as vacuum-assisted closure (wound VAC) and hyperbaric oxygen Chambers, could help close sores that were left untreated in his time.

History may have looked very different if King Henry had not fallen from his horse launching a cascade of medical problems. Today, we can learn from his misfortune and take advantage of current wound care treatments which avoid unnecessary suffering, and possibly, change the course of our history.

Jill Kruse, D.O. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at http://www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show celebrating its 20th season of truthful, tested, and timely medical information streaming live on Facebook most Thursdays at 7 p.m. central.