Here - EWMA 2013

ORAL PRESENTATIONS
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Debra Guest Session: Presentation of the Wound Care Guidelines
Challenging Situations – Epidermolysis Bullosa (EB) and
presentation of the wound care guidelines
Jackie Denyer 1 , Liz Pillay
1 Dermatology, EB Department London;
2 DEBRA (London, United Kingdom).
This symposium will give an overview of the complexity of skin and wound management
in EB. Short presentations will focus on the role of international guidelines, novel wound
treatments and the development of a successful range of retention garments.
Epidermolysis bullosa is a rare genetically determined skin fragility disorder. There are 4
major types of EB and many further sub-types.
Depending on the type of EB the effects vary between simple blistering of the hands and
feet, progressive disability resulting from scarring or in its most severe form, death in
early infancy.
This complex condition requires multi- disciplinary input and management is best
achieved within a specialist centre.
In the UK we are fortunate to have a wealth of resources readily available to our patient
group, offering a choice of suitable dressing materials and topical products in order to
aspire to the best practice. Our large combined caseloads enable us to source and trial
novel wound care products. We will show case studies demonstrating the effectiveness
of keratin technology and piscean collagen.
Managing patients with severe forms of EB in under resourced areas is more
challenging and requires adaptation of available materials which are not necessarily
designed for wound care.
Even in the best resourced areas there is a lack of products specifically designed to
meet the needs of those with extensive whole body wounding as seen in severe
epidermolysis bullosa. The WEB (Wound care for EB) is a novel collaborative project
which is addressing these problems, and as a first stage has produced a range of
dressing retention products.
FREE PAPER SESSION: DIABETIC FOOT II
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Free Paper Session: Diabetic Foot II
Time to healing foot ulcers among patients with type 1 and
type 2 diabetes have decreased in the period 2002-2010
Anne Rasmussen 1 , Annemette Nielsen 1 , Thomas Almdal 1 , Kirsten Engelhard Nielsen 1 ,
Ulla Bjerre-Christensen 1 , Per Holstein 1
1 Steno Diabetes Center (Gentofte, Denmark).
Aim: Was to study the changes in healing foot ulcers in two large cohort of type 1 (T1D)
and type 2 (T2D) diabetes patients.
Methods: A cohort study comprising 5.216 T1D and 6.376 T2D patients treated in a
multidisciplinary center. When ulcer is observed the patients is seen immediately and
offer standard treatment. All information is housed in an electronic patient record. We
studied healing time of ulcers, number of visits, days without ulcer within 3 years after
healing and comobidity.
Results: The period 2002-2010 a total of 2041 ulcers were diagnosed. From 2002-04 a
total of 702 ulcers, in 2005-07 665 ulcers, and in 2008-10 674 ulcers. 62% of the ulcers
were diagnosed among T2D, 38% T1D. All foot ulcers healing time decreased from 106
days in 2002-04 to 84 days in 2008-10. For T1D patients healing time decreased from
126 to 98 days, T2D healing time decreased from 99 days to 84 days. Change in
treatment time is in relation to toe ulcers. In 2002-04 patients were seen 6,5 times before
healing of the ulcer, in 2008-10 this was reduced to 4 times. Among patients where
ulcers healed in 2002 21% were free of any new ulcer in 2008 53% in subsequent 3
years.
Conclusion: The study shows that heling time of ulcers decreased significantly from
2002 to 2010. The number of vistis in the foot clinic have decreased significantly and
there was a trend towards an increase in ulcer free days.
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