Here - EWMA 2013

POSTER PRESENTATIONS
P 352
SKIN NECROSIS DUE TO ORAL ANTICOAGULANT TREATMENT:
A RARE BUT SERIOUS COMPLICATION.
Poster: Case Study
Kawtar Beqqal 1 , Anne Philippe 2 , Marie-Hélène Horellou 3 , Isabelle Gorin 1 ,
Marie-Françoise Avril 1
1 Service de Dermatologie,APHP HôpitalTarnier Cochin (Paris, France);
2 Consultante plaies et cicatrisations,APHP Hôpital Saint- Antoine (Paris, France);
3 Service d’hématologie biologique,APHP Hôpital Hotel-Dieu (Paris, France).
Aim: Skin necrosis is a rare complication of oral anticoagulants but a serious and
difficult to manage. We report our experience of management and treatment of skin
necrosis in a patient with protein C deficiency.
Case Study: A large skin necrosis is reported in a 42 year old woman affected by a
severe protein C deficiency, treated for proximal venous thrombosis. Five days after the
initiation of oral anticoagulant treatment, she developed on the left calf, an extensive
skin necrosis followed by an ulcer.
Discussion and Conclusion: Skin necrosis is a rare complication of oral anticoagulants
which occurs at the initial phase of the treatment, particularly in patients with severe
protein C deficiency. Only few cases have already been reported in the literature.
However, the knowledge of the kinetic of the vitamin K dependant factors inhibition by
oral anticoagulants and adequate therapeutic approaches might avoid this complication.
POSTER: CASE STUDY
P 353
Poster: Case Study
First experience using a multi-function product gel containing
Silver Sulphadiazine 1%
Sara Bradbury 1 , Nicola Ivins 1 , Keith Harding 1
1 Wound Healing Research Unit (Cardiff, United Kingdom).
Aim: To evaluate the efficacy of a multi-function product (MFP) in the treatment of
patients with chronic wounds with evidence of infection.
Method: The 4 patients included in the evaluation were all diagnosed with a venous leg
ulceration, which required use of a topical antimicrobial. All patients had wounds with
odour, localised infection and heavy exudate. The MFP was applied twice weekly along
with their standard compression. The patients were assessed weekly using clinical
measurements of wounds, including length and width, along with pain severity scores,
wound exudate and odour. Photographs were taken at regular intervals and verbal
feedbacks from the patients were reported.
Results: Patients were followed for approximately 30 days or until it was no longer
necessary to use an anti-microbial. All patients showed a reduction in the appearance of
infection including the level of exudate. The MFP eliminated odour for all 4 patients. No
patients experienced pain on application of the MFP, and there was no residue left in the
wound bed when the dressing and bandage were renewed. All patients’ wounds showed
an increase in the percentage of granulation tissue. The MFP appeared to be very
effective at eliminating odour after 1 or 2 applications.
Discussion: Initial experiences were positive, the MFP containing silver sulphadiazine
1% appeared to be effective at reducing infection in the wound bed. The gel formula was
easy to apply and did not appear to cause any complications to the surrounding skin.
Although experience is limited results suggest further clinical work would be valuable.
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