Here - EWMA 2013

POSTER: PREVENTION
Poster: Prevention
P 338
Can the number of major amputations be reduced?
Rolf Jelnes 1
1 Sygehus Sønderjylland (Sønderborg, Denmark).
Introduction: Due to demographic changes over the years to come, an increase in the
number of major amputations is to be expected. An amputation is very troublesome for
the patient and at a heavy socio-economic cost to the society.
Material: Retrospective study on major amputations perofrmed during the 9-year period
2002-2011 at Sygehus Sønderjylland – background population approx. 225.000, code:
KNFQ19,KNGQ19,KNGQ09
Results: 407 major amputations were performed during the 9-year period.
2002-5: 172, average: 57,3/year
2005-8: 119, average: 39,6/year
2005-11: 116, average: 38,6/year
Since 2005, we continuously have focused on wound care and cross-sectional
collaboration and over time applied different low-tech technologies, such as
telemedicine, dynamic insole test and recently 3D scan of the foot.
Conclusion: The number of major amputations can be reduced through a combined
effort of close collaboration of wound care specialists and vascular surgery. The changes
in the number of amputations caused by arterial insufficiency, diabetic neuropathy and
neuroischaemia over time will be presented.
P 339
EXTENSIVE BURNS SYSTEM TREATMENT
Poster: Prevention
G.P. Kozinets 1 , V.P. Tsygankov 1
1
Center thermal trauma and plastic surgery (Ukraine).
Purpose: To develop extensive burns patient’s treatment system, in order to protect
them against infectious complications.
Methods: clinical, haematological, microbiological, immunological studies. Defined
factors are fundamental in prevention of infectious complications: – Dermal surface
burns preferential contamination with Staphylococcus epidermidis, deep dermal –
associates of Pseudomonas aeruginosa and Staphylococcus aureus;
Modern antiseptics use for wounds treatment within treatment period (quaternary
ammonium compounds, pyridine);
– Coatings use after burn wounds surgical treatment (biological, synthetic, or combined)
including wound healing development phase;
– Patients time delivery shortening to special stage: up to 24 hours for adults, up to 12
hours for children;
– Antibiotic therapy early prescription of for adult patients with body surface burn area
more than 10-12% and for children – more than 1-5% (cephalosporins III generation +
amino glycosides for superficial dermal burns, carbapenems or IV generation of
cephalosporins + nitroimidazoles against deep dermal and subfascial burns);
– Early excision of necrotic tissue in period from 2-nd up to 8 – 10 day with primary
excision up to 50% of necrosis with simultaneous wounds closure;
– Restoration of lost skin and donor sites healing of patients with critical burns in period
up to 40 days;
Due to the developed and implemented activities in departments and centers of Ukraine,
it was reached: -reduction of mortality of burned patients in Ukraine:
adults from 5.0% to 3.5% (30%);
children from 0.45% to 0.24% (46.7%);
Reduction of local and systemic infection complications in burned on 25%.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
199