Here - EWMA 2013

POSTER: CASE STUDY
Poster: Case Study
P 378
Edema Treatment of Externally fixated(EF) Ankle Fractures
Nina Bækmark 1 , Jonas Hedegaard Andersen 1 , Mikkel Sundstrup 1
1 Hillerød sygehus (Hillerød, Denmark).
Aim: To demonstrate how to reduce edema in patients with EF after ankle fractures,
because edema isn’t just painful for the patient, it increases risk of infections, deep
venous thrombosis and delays secondary operations.
Method: We have developed a special regime of Compression Bandages (CB) and
Intermittent Pneumatic Compression (IPC) for externally fixated ankle fractures. IPC is
initially used to alleviate the edema, and consists of a calf and a foot pump. When the
swelling is reduced we switch to CB.
In special cases were the swelling is extreme or refractory to treatment a combination of
IPC and CB can be used.
Result: Application of the regime has resulted in significant reduction in pain
experienced by patients, and a reduced sensation of heaviness. We note that there is a
reduction in exudates from pinholes, a reduction in pinhole infections, reduced pressure
ulcer tendency.
Discussion: Because EF is often used on severe and open fracture, these have a
tendency to produce more edema than other ankle fractures. The edema can result in
pressure ulcers, when the swollen skin presses up against the frame. As exudates
produced at the pinholes, can result in infections and edema is a known factor in patient
pain management, and patients often complain of a sensation of heaviness in the leg.
We therefore believe there is objective evidence to edema treat patients with EF, but a
larger project would be desirable to implement to verify our assumption.
P 379
Poster: Case Study
A case study of Emergency Room (ER) Compression Treatment of
Hematoma
Mikkel Sundstrup 1 , Nina Bækmark 1 , Jonas Hedegaard Andersen 1
1 Hillerød sygehus (Hillerød, Denmark).
Aim: Patients, who suffer large soft-tissue damages, are often afflicted with large
hematomas and edemas, which can result in necrosis of soft tissue.
The aim of this poster is to show that damages and time of treatment can be severely
reduced by compression therapy applied in the ER, when treating wounds of a nature
like the presented cases.
Methods: We submit photographic documentation of one case of impending severe
necrosis of soft tissue, emerging from a large hematoma, incurred after a fall. The
necrosis was avoided by compression treatment, in unity with surgery.
This case is compared with a case were compression therapy was initialized in the ER.
This patient sustained a crush trauma to her calf, resulting in a massive hematoma and a
laceration dorsally. It was treated with compression and surgery.
Result: The two cases show what we consider to be a significant difference in treatment
time, when compression therapy was applied immediately.
Discussion: We have only now begun to investigate the effect of compression therapy
applied in the ER. More documentation will be needed. This goal can be reached by
educating ER physicians and nurses in compression therapy, and use photo
documentation and questionnaires. We are convinced that further studies will show an
significant effect in hematoma therapy.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
219