Here - EWMA 2013

POSTER: CASE STUDY
Poster: Case Study
P 386
Experiences of living with a gout with a recurrent wound:
A qualitative study.
Shu-Chuan Lo 1 , Shu-Fen Lo 2
1 Department of Nursing, Buddhist Tzu Chi General Hospital (Taitung, Taiwan);
2 Tzu Chi College of Technology (Hualien, Taiwan).
Aim: The purpose of this study was to explore the experience of patients living with a
recurrent wounds.
Methods: Using a qualitative approach ten in-depth interviews were conducted with
patients in one community center in Taiwan. Data were subject to a thematic analysis
informed by elements of grounded theory.
Results: Five key themes demonstrated an emerging model that offers an insight into
how patients experience their wound. Firstly, unalleviated pain refers to the initial impact
of the wound, this is linked to two further themes; information shortage about gout with a
recurrent wound and the misconception on wound management methods. Low mood,
anxiety, frustration were attributed to the added impact of gout with a recurrent wound on
their lives. Perceptions of impact fluctuate over time in relation to physical symptoms
experienced by participants and the additional social limitations imposed by the ulcer
P 387
Surgical treatment of Darier disease: a case report
Poster: Case Study
Donatas Samsanavicius 1 , Karolina Liubinienė 2 , Jaunė Andziukevičiūtė 3 , Kęstutis
Maslauskas 1 , Vygintas Kaikaris 1 , Rytis Rimdeika 1 , Skaidra Valiukevičienė 2
1 Hospital of Lithuanian University of Health Sciences, Department of Plastic and
reconstructive surge (Kaunas, Lithuania);
2 Hospital of Lithuanian University of Health Science, Department of of Skin and Venereal
Diseases (Kaunas, Lithuania);
3 Lithuanian University of Health Sciences (Kaunas, Lithuania).
Darier disease (Keratosis folicullaris) was described independently by Darier and White
in 1989. It is one of the most common genodermatoses, with an incidence of 1:30,000 –
100,000. This disease is a result of mutation in the ATP2A2 gene. The typical lesions are
yellow – brown keratotic papules or plaques, usually found in the seborrheic areas such
as scalp, forehead, retroauricular folds, neck, chest, axillae and extremities.
Aim: The Aim is to evaluate the results of surgical treatment of Darier disease.
Materials and Methods: A 41-year-old man presented with keratotic lesions on the feet
and palms since 25 years. Patient was treated with emolliants, keratolytics (salicylic acid,
urea), PUVA therapy, and systemic retinoids (isotretinoin), but treatment was without
improvement. Examination revealed multiple keratotic yellow plaques on the palms.
Exophytic keratotic warty texture papules were seen on the feet. Cysts and closed
comedones were on the skin of face and chest. Surgical excision of keratotic masses
surgical on feet was made. Firstly, partial excision of medial surface on the right sole on
the level of healthy derma was made. The wounds were left for epithelization. Second
keratotic masses excision was made after five months on the right sole and after six
months on the left sole.
Results: Re-ephitelialization on the excision site was observed and there weren’t
evident signs of infection and recurrence.
Conclusions: Surgical excision of keratotic masses can be successesful treatment of
Darier disease for patients who don’t respond to topical and systemical treatment.
Conclusions/Discussion: Participants indicated that gout with a recurrent wound
impacted on their health-related quality of life across physical, social and psychological
domains. The findings of this study can provide a reference for clinical nurses who want
to implement the model to provide a comprehensive care.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
223