Here - EWMA 2013

FREE PAPER SESSION: MISCELLANEOUS
Free Paper Session: Miscellaneous
134
ATYPICAL WOUNDS AND ATYPICAL CAUSES
Karsten Fogh 1 , Jes Velling 1
1 Dept. of Dermatology, Aarhus University Hospital (Aarhus, Denmark).
Aim: Atypical wounds are characterized by marked inflammation and tissue necrosis.
Diagnoses can include pyoderma gangrenosum, vasculitis, malignant wounds and
wounds associated with systemic conditions such as inflammatory bowl disease,
rheumatoid arthritis and haematological disease. In the present study we describe
patients with atypical wounds and unusual and unexpected causes.
Method: In a retrospective study 7 patients were identified and patient records were
evaluated for associated diseases, skin changes, ulcer characteristics, histological
examination of ulcer margin biopsy specimens, treatment results and clinical course of
the disease.
Results: The following unexpected associations were observed: malignant melanoma in
a patient with rapidly progressing pyoderma gangrenosum, metastasising lung cancer in
a patient with severe cutaneous vasculitis, a vasculitic ulcer in a patient with systemic
scleroderma, warfarin-induced cutaneous wounds in a patient with severe diabetes,
vasculitis in a patient with widespread diabetic angiopathy, vasculitis in a patient with
alpha 1 antitrypsin deficiency and abscess formation later diagnosed as a squamous cell
carcinoma.
Conclusions: We have identified patients with atypical wounds and identified
unexpected and unusual causes and associations. The present study shows that
atypical wounds should be considered in patients presenting with wounds not covered
by traditional and frequent diagnoses such as venous, ischaemic and diabetic ulcers.
Furthermore, attention should focus on systemic factors in patients with atypical wounds.
135
Free Paper Session: Miscellaneous
PAIN MANAGEMENT REGARDING NON-HEALING WOUNDS FROM NURSES
VIEWPOINT
Andrea Pokorná 1 , Markéta Koutná 2
1 Masary university, Faculty of Medicine, department of Nursing (Brno, Czech Republic);
2 General University Hospital, Prague (Prague, Czech Republic).
Aim: The abstract is focused on the description of the survey among nurses working with
patients with non healing wounds. The survey was done across the Czech Republic. We
evaluated knowledge of nurses in regard to the pain management in patients with non
healing wounds (using of the pharmacotherapy and non-pharmacological approaches
and documentation of the pain during the care).
Methods: The questionnaire survey was done among 250 nurses working in the different
care settings in the Czech hospitals. Criteria for inclusion in the study – daily contact with
patients with non-healing wounds, at least one year of clinical practice.
Results: All of the respondents worked with patients with non-healing wound. Most of
them treats patients with pressure sores and leg ulcers, all stated that their patients have
chronic pain and also suffers from acute pain during the treatment procedures. As the
most problematic part of the pain management was not appropriate evaluation of the
characteristic features of the pain (mostly evaluate just the level of the pain).
Conclusions: Nurses in our sample declare a lack of knowledge in the management of
pain in patients with non-healing wound. The biggest problem is the use of appropriate
evaluation scales and the subsequent use of pharmacological and non-pharmacological
methods of pain relief. Problem is also the dependence on physician prescription and the
impossibility of influencing the current state of the patient in a short period of time (in
connection with bandaging and changes of the therapeutic materials).
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
87