Here - EWMA 2013

POSTER PRESENTATIONS
P 356
Poster: Case Study
MANAGEMENT OF A LYMPHEDEMA PATIENT WITH A TWO COMPONENT RIGID
COMPRESSION SYSTEM – A CASE STUDY
Ria van Dam 1 , Alice van den Wijngaard 2
1 Boerhaave Foundation for Nursing homes, location: St. Jacob (Haarlem, Netherlands);
2 Lohmann & Rauscher (Almere, Netherlands).
Aim: Lymphedema may be caused by phlebological disorders, trauma, surgery or
oncology. Therapy is delivered by a multi-disciplinary team and comprises: skin care;
exercise; high stiffness compression (SSI >10) and lymph drainage therapy. Patient
guidance, education and motivation is key in the delivery of lymphedema treatment.
The aim of this case study was to provide improvement of the patients ‘quality of life,
achieving complete debridement, closing the lesions and providing comfortable and
effective lymphedema management.
Method: Case ascertainment was used in the 84 year-old male patient with combined
venous lymphatic lesions, blisters and massive oedema in both lower legs and feet. The
lesions appear infected with Pseudomonas aeruginosa. The complete regime was
revised, using a *monofilament debrider wetted with PHMB for debridement of the
lesions and removal of scabs; a **non-adhesive foam dressing and a less bulky ***two
component compression system. The toes were included in the compression bandage
and specialist lymphedema footwear was used.
Results: After one week the skin lesions had closed and the oedema reduction was 9,6
cm (measured at the calf). Compression with the two component system was continued
for another three weeks, after which he received a ****tubular compression system for
maintenance therapy, continuing with skin care and specialist footwear.
Conclusion: The treatment regime allowed for fast closure of the lesions and effective
reduction of the lymphedema in a patient-friendly manner, improving the patients
mobility and quality of life.
*Debrisoft
**Suprasorb ® P
***Rosidal ® TCS
****Actico Silk, Lohmann & Rauscher
POSTER: CASE STUDY
P 357
Poster: Case Study
COMPLEX CASE SERIES OF FOUR DIFFERENT STAGNATING WOUND TYPES
TREATED WITH A COLLAGEN DRESSING
Stella Amesz 1 , A van Zandbergen 1
1 Wond Expertise Centrum en Zorg Brug (Gouda, Netherlands).
Aim: Efficacy of a *collagen dressing on inflammation reduction and re-starting healing
was evaluated in four patients with stagnating wounds of different aetiologies.
Methods: Case ascertainment was used. Patients had a mean age of 59 years (SD ±
23,19) Patients received a *collagen dressing and a **foam or an ***alginate as a
secondary dressing, for a maximum of 14 days, after which the collagen dressing was
discontinued and the foam used as a primary dressing. Wound healing was assessed
using clinical observation and digital photographs, comparing day 0 versus day 14
results. Patients were then followed until wound closure.
Results: Patient 1: Mentally retarded 19-year-old male with a stagnating stage three
sacral pressure ulcer. After three weeks signs of healing were evident and wound
closure was achieved in 12 weeks. Patient 2: Sixty-nine year old frail female with
multiple pathologies who had a stagnating wound after knee implant surgery. After three
weeks of collagen dressing use her wound improved and went on to healing within 30
weeks. Patient 3 and 4 underwent a resection of a facial basal cell carcinoma which
resulted in a stagnating wound, after skin grafting failed. The wound of patient 3 was
closed within 14 weeks and for patient 4 healing was achieved within 14 days.
Conclusion: The case series results indicate the use of collagen to effectively start up
the stagnating healing process.
*Suprasorb ® C
**Suprasorb ® P
***Suprasorb ® A, Lohmann & Rauscher
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