Here - EWMA 2013

EWMA UCM LECTURE
Key Session: E-health and the Future of Health Care Systems
114
Mobile wound healing center using telemedecine: Analysis of
a database including 5795 patients and perspectives
Luc Teot 1 , C. Trial 1 , J. Lan 1 , E. Riba 1 , S. Palmier 1
1 University Hospital Montpellier (Montpellier, France).
Introduction: The Home Hospital Wound Healing Network (HHWHN)is an expert
network advising professionals GPs and nurses willing to get help in wound healing.
These experts got a diploma in wound healing and are regularly trained and tutored. The
Network uses since 10 years a system of teletransmission of clinical datas and pictures
using computers and smartphones and rassembled on a special software. 5794 patients
were inclused between January 2005 and October 2012 in this database. Functionalities
of the database are detailed. Clinical efficacy and medicoeconomic results are analysed
Results: Patients presenting polypathologies are the majority. Types of wounds
analysed in the software are principally pressure ulcers (42%), leg ulcers (22%), diabetic
foot ulcers (8%), postop wounds complications representing 12%. The mean length of
study is 76 days. Economical markers show a reduce of costs in the management of
wounds compared to previous hospitlaisations and transportations from home to wound
healing centers.
Conclusion: There is an increasing demand of assistance from professionals not
specialised in wound healing facing complex wounds. The territorial coverage by a
network of expert nurses and doctors may help to manage these pathologies which
represent a high economical burden.
115
EWMA UCM Lecture
The inflammatory response is regarded as the first of a number of
overlapping processes that constitute wound healing
Judit Daróczy 1
1 Lymphoedema Rehabilitation Department (Hungary).
Definition of the inflammation: Tissue injury causes the immediate onset of acute
inflammation. Inflammatory cells secrete enzymes and various mediators that result in
the classical hallmarks of inflammation: pain, redness, warmth, and swelling. It has been
demonstrated that the inflammatory response during normal healing is characterized by
spatially and temporally changing patterns of various leukocyte subsets.The
development of effective inflammatory models that track the dynamic balance between
changes in systemic neutrophil availability and their recruitment to the wound is
important in identifying the mechanism that leads to normal or aberrant wound healing.
In the early stages of wound healing, keratinocytes become activated and release
inflammatory molecules such as IL-1 and IL-8, which are linked to innate immune
responses and neutrophil recruitment. Fibrocytes are mesenchymal cells that arise from
monocyte precursors. They are present in injured organs and have both the
inflammatory features of macrophages and the tissue remodelling properties of
fibroblasts. Chemokines (IL-8) stimulate angiogenesis and keratinocyte proliferation,
they integrate the inflammatory events with the reparative processes.
The role of inflammation in wound healing: The healing process of skin wounds is
regulated by growth factors which stimulate proliferation of connective tissue cells,
keratinocytes and their synthesis of extracellular matrixcomponents. Different leukocyte
subtypes (neutrophils, macrophages, lymphocytes and mast cells) participate in wound
healing not only as immunological effector cells but also as an important source of
inflammatory and growth promoting cytokines and growth factors.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
77