Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 516
E-Poster: Leg Ulcer
Dermoscopy-diagnostic method of microangiopathy in chronic
venous ulceration
Javorka Delic 1 , Vesna Mikulic 1 , Vesna Vlahovic Tatljak 1
1 Serbian Wound Healing Society (Belgrade, Serbia).
Microangioathy in postthrombotic chronic venous ulceration (CVU) is the consequence
of venosus hypertension, stasis, chronic inflammation and reparative processes.
Objective: The presentation of the blood wessels and pigmentation of the papilar
dermis by dermoskopy*, Delta 20. 57 patients, with CVU, which is confirmed by clinical
and Color Doppler exams, 32 female, 25 male, with fotodocumentation–clinic image,
dermoscopy.
Results: Venous capillares in papilar dermis:dilated, derformed, like lacuna, individual
or grouped in globula formation and often, in formation like pomegranate (more globula),
which is localised near of CVU. On places of atophy or sclerosys there werent visible
blood wessels and the pigment deposites. Pappering. Maccular pigmentation, very
tipical finding, is the sign of the increasing acitivities of the macrophags, usually
increasing in lymphoedema, inflammation, infection. Pappering was the most enlarges
on zones near the cicatrix. Pseudo–network localised near of CVU, (hemosiderin,
melanine) present the residual pigmentation in stasis dermatitis. Also, a sign of the
phenomena of lowering melanines in deeper leyer beacouse of the disturbance of basal
membrane and epidermal barrier. Dermoscopy as a diagnostic method of the
microangiopathy, is representing different pigment deposites, disturbance of blood
wessels as lakuna, globulas, pomegranate, atrophy and sclerosis of the skin. On the
results has influence the type of the skin (Fitz–Patrick), sex (estrogen depended
pigmentation) but the most importante influence have the stadium of HVI (stadium C5
and C6).
Key words: Dermoscopy, chronic ulceration, pigmentation, blood wessels
*HEINE
E-POSTER: LEG ULCER
EP 517
DECREASED LOWER LEG EDEMA IMPROVED WOUNDS HEALING
E-Poster: Leg Ulcer
Wen-Chang Cheng 1 , Haiyan Wang 2
1 Chung Shang Medical University Hospital (Taichung, Taiwan);
2 Anhui University of Traditional Chinese Medicine (Anhui, China).
Purpose:
The idea that dry type therapy is better than moist therapy in healing deep
wounds was presented by Dr. Wen-Chang Cheng in 2012 EWMA. The current NPWT
and compression therapy of lower leg promote wound healing maybe associated with
decreased wound exudate. To evaluate the relationship of wounds healing and exudate
by oral diuretics, and observation of decreased exudate of wounds on lower leg is
designed in this study.
Methods: A study of 20 problem wounds with delayed healing in proliferation phase
more than 3 months were selected. Prescription of oral diuretic, furosemide 40 mg daily,
and wound therapy performed simultaneously. Before and after the research, the same
method of wound care is performed. The circumference of midfoot is measured. The
edema of foot, wound exudate and moisture of dressings were also evaluated.
Results: Average circumference of midfoot is 25.8 cm before study and 24.5 cm after
study. Average wounds size is 21.2 cm 2 , and average healing time 29.4 days was noted
in this study. Lower leg edema improvement, skin wrinkles, and eschar formation easily
were also observed. However two cases with complications by oral diuretics, one is
dizziness and another one palpitation were recorded in this study.
Conclusions: Decreased edema of lower leg, then improved the wound healing in this
study. Decreased wound exudate, delayed epithelial rolling, and made granulation phase
progressed smoothly. Decreased edema maybe make bacteria colony decreased, and
promoted wound healing. Systemic decreased edema can improved wound healing of
lower limb.
*VAC
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