Here - EWMA 2013

E-POSTER: LEG ULCER
E-Poster: Leg Ulcer
EP 518
A NOVEL EGF-CONTAINING WOUND DRESSING FOR THE TREATMENT OF
RECALCITRANT CHRONIC LEG ULCERS
Martin Doerler 1 , Sabine Eming 2 , Joachim Dissemond 3 , Markus Stücker 1
1 Vein Center, Departments of Dermatology and Vascular Surgery, Ruhr-University
Bochum (Bochum, Germany);
2 Department of Dermatology, University of Köln (Köln, Germany);
3 Department of Dermatology, University of Essen (Essen, Germany).
Aim: To evaluate the efficacy, tolerability and safety of a novel wound dressing
containing Epidermal Growth Factor in a spongeous matrix for the treatment of
recalcitrant chronic leg ulcers.
Methods: Three specialized German wound centers included 33 patients (20 females,
13 males) with recalcitrant leg ulcers (31 venous, 1 arterial, 1 post-radiation). The EGFcontaining
wound dressing was applied three times while best practice conservative
wound treatment was continued. The patients were followed up 1, 2 and 3 months after
treatment to evaluate: a) the measured wound size, b) the ease of application, c) the
resorption of the dressing, and d) the wound dressing by means of a scale ranging from
1-5 (1 = best, 5 = worst).
Results: The protocol was completed by 27/33 patients. The reasons for discontinuation
were: wound infection (n=2), pain (n=1) and increased wound size (n=1). Two additional
patients lost to follow-up after 2 and 3 months. At the end of the study, three ulcers were
completely healed. Overall, the mean wound surface decreased from 37.36 cm 2 to 23.33
cm 2 (-14.03 cm 2 ). The wound dressing was evaluated as easy to apply and resorbable
by patients and wound care specialists. The mean subjective evaluations of the novel
wound dressing were 2.17 for wound care specialists and 2.4 for the patients.
Conclusion: Our results demonstrate that the novel EGF-containing wound dressing
was generally well tolerated and safe. The reduction of wound size needs to be
confirmed in a randomized controlled trial.
EP 519
E-Poster: Leg Ulcer
DIFFERENTIAL DIAGNOSIS OF LEG ULCERS – ULCERS OF RARE ETIOLOGIES
András Kovács L. 1 , Zsolt Kádár 1 , Endre Kálmán 2 , Krisztián Molnár 3 , Dalma Várszegi 1 ,
Eva Varga 1 , Mehdi Moezzi 1 , Imre Schneider 1
1 Department of Dermatology ; University of Pécs, Medical School (Pécs, Hungary);
2 Department of Pathology ; University of Pécs, Medical School (Pécs, Hungary);
3 Department of Radiology, University of Pécs, Medical School (Pécs, Hungary).
Aim: Chronic wounds without a tendency to heal present a serious public health and
economic issue. With the case reports the authors present ulcers of rare etiologies,
emphasising the importance of performing differential diagnosis before treatment.
Methods: In 2012 the authors have treated 268 patients with leg ulcer in their
department of dermatology. In cases of chronic, non-healing ulcers with an atypical
wound and medical history a sampling excision was performed in order to establish a
correct diagnosis. From the new patients treated in 2012 the authors present 7 cases of
leg ulcers, including 6 various, rarely occuring ulcers.
Case 1: ulcerous basalioma (91 years old female, ulcer since 2.5 years);
Case 2: ulcerous squamous cell carcinoma (82 years old female, ulcer since 2-3 years);
Case 3: squamous cell carcinoma developed from a chronic leg ulcer (71 years old
female, recrudescent ulcer since 2 years);
Case 4: pyoderma gangrenosum (70 years old male, ulcer since 4 months);
Case 5: pyoderma gangrenosum (67 years old female, ulcer since 1.5 years)
Case 6: ulcer associated with lichen sclerosus et atrophicus (61 years old female)
Case 7: ulcer associated with scleroderma-rheumatoid arthritis overlap syndrome (58
years old female, ulcer since 6 years).
Results: Histological examination of ulcers without a tendency to heal performed based
on the clinical picture proved to be beneficial in establishing the correct diagnosis.
Conclusion: The primary aim of modern wound management is determining the disease
causing the ulcer, treating the condition inducing the healing disorder, namely causal
therapy. In cases of chronic ulcers resistant to therapy, ulcers of rare etiologies, such as
malignancies, pyoderma gangrenosum or ulcers associated with autoimmune diseases,
also have to be considered during differential diagnosis. Establishing the correct
diagnosis as early as possible is substantial regarding the fate of the patient, the chosen
therapy, the effectiveness and cost of the treatment and the healing of the chronic
wound.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
295