Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 576
SWIM TO CICATRIZE OR THE WAY THE WOUND DRESSING LEADS TO
THERAPEUTIC EDUCATION
E-Poster: Case Study
Nicole Tagand 1 , Hugues Lefort 2 , Pjotr Gryc 3 , Germaine Dossantos 4 , Yves Irani 1 ,
Dominique Casanova 1
1 1. Plastic Surgery Department – La Conception Hospital (Marseille, France);
2 2. Emergency Medical Care Service – Fire and Rescue Brigade of Paris (Paris,
France);
3 3. Visceral surgery service, University Hospital of Sarrebourg (Sarrebourg, France);
4 8. Diabetes Therapeutic Education department (Marseille, France).
Introduction: The wound healing can be altered by several factors leading to chronicity.
We are to present a casuistry of a non-treatable patient negligent of his wound and
diabetes. The appropriate wound dressing application form regarding the patient’s sport
motivations leads to complete cure and first to his therapeutic education.
Patient: The observation applied to a 70 year old patient suffering from obesity and
diabetes and presenting a lesion to the lower extremity that became chronic due to an 8
months negligence period. The patient clamed for the hyperbaric treatment procedure to
recover rapidly. Used to be a great athlete he wanted to join the « Monté Christo »
swimming competition taking place between Marseille and Chateau d’If.
Results: Thanks to the secondary waterproof wound dressing he started immediately
the training and was able to compete. The sport training included food and glycaemia
management, regarding physical efforts. Became the main character he will go ahead
and succed.
Discussion: Immediately satisfied, the patient agreed to a long-term active
engagement. Well known competition frame permit the patient to accept the rules and
his own part in process. Connecting sport, nutrition and health management, he
appropriated the abilities to improve his diabetes care. No longer passive, he became
participant, a partner of his cure, to improve his health. He subscribes in the therapeutic
education, a process leading to a long term autonomy.
E-POSTER: CASE STUDY
EP 577
THE MANAGEMENT OF STAGE IV PRESSURE ULCER IN SACRUM
E-Poster: Case Study
Heui-Yeoung Kim 1
1 81 ward/ Dong-A university hospital (Busan, Korea).
Aim: To evaluate the benefits of using a fecal management system in patients with liquid
or semi-liquid fecal in continence who stage IV pressure ulcer ulcer in sacrum. To assess
efficiency of negative pressure wound therapy for patient with stage IV pressure ulcer in
sacrum.
Methods: 72-year old male who had been suffering from spinal cord infarction in
bedridden. The wound was situated in the sacrum region, and on initial assessment
measured 8cm long x 6.2cm wide x 5cm deep. The wound bed presented with 50%
slough and 50% necrotic tissue, producing high levels of serosanguinous exudate. This
wound was treated with NPWP. He began having incontinent liquid stools, at frequency
of ten times per day. A catheter-based bowel management system was inserted.
Results: 7 weeks later. There was a marked reduction in the size of the wound: 5.5cm
long x 5cm wide x 2.5cm deep. Exudate level was reduced, and the base of the wound
was granulating and contracting. There remained a small amount of slough which was
resolving slowly and the edges were epithelialising. The fecal management system may
contribute to treatment for the pressure ulcer was more effective.
Conclusions: This case study has shown that NPWP is an effective method of wound
therapy for patients with stage IV in sacrum. The advantages of the fecal management
system included, for this case, fewer dressing changes, enhanced patient comfort, skin
and wound protection, and simplification of patient care.
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