Wound digest
This digest summarises recent key papers published in the areas of pressure ulcers, skin integrity, venous leg ulcers and diabetic foot ulcers.
SELECTED PAPERS OF INTEREST 1. Identification of patient characteristics and comorbidities associated with Pyoderma gangrenosum 2. International consensus on the prevention and management of skin tears 3. Improving understanding of the role of friction forces and pressure forces in pressure ulcer aetiology and classification
4. Identifying the 'at-risk' foot in clinical practice 5. Importance of limb preservation in people with diabetes
To compile the digest a Medline search was performed for the three months ending in October 2011 using the search terms ‘pressure ulcers’, ‘skin integrity,’ ‘leg ulcers’ and ‘diabetic foot ulcers’. Papers have been chosen on the basis of their potential interest to practitioners involved in day-to-day wound care. The papers were rated according to readability, applicability to daily practice, and novelty factor.
Leg Ulcers 1
Identification of patient characteristics and comorbidities associated with Pyoderma
gangrenosum
Readability Relevance to daily practice Novelty factor
n Pyoderma gangrenosum (PG) is a rare, painful ulcerating disease associated with a variety of comorbidities
n This study involved a detailed, retrospective evaluation of the clinical presentation, demographics, and therapeutic modalities used in 103 adult patients with a diagnosis of pyoderma gangrenosum (PG)
n The leg was the most frequent site for PG (77.7%) while the trunk was reported in 11.7%, peristomal site in 8.7%, the upper extremities in 8.7%, and the head and neck in 7.8%
n The data supports that PG is associated with female predominance, inflammatory bowel disease, haematological disorders, hepatitis, major depression, and a significant mortality rate (16%)
n While the authors state that a cohort of 103 is relatively small in comparison to studies of more common diseases, PG is a rare disease and this is possibly the largest published PG case series.
Binus AM , Qureshi AA, Li VW, Winterfield LS, Pyoderma gangrenosum: a retrospective review of patient characteristics,omorbidities, and therapy in 103
patients.Br J Dermatol 2011 doi: 10.1111/j.1365- 2133.2011.10565.x. [Epub ahead of print].
Skin integrity 2
International consensus on the prevention and management of skin tears
Readability Relevance to daily practice Novelty factor
n This international consensus document on the prevention and management of skin tears was based on a two-day roundtable discussion involving 13 key opinion leaders
n A three-phase modified Delphi Method was used to reach consensus on a skin tear definition and 12 statements are proposed within the document
n The document asserts that skin tears are perceived to be common wounds and occur more frequently than pressure ulcers
n A collaborative multidisciplinary approach should be utilised for skin tear prevention and management
n The statements presented describe in detail the measures that should be taken to prevent and manage skin tears
n Statement 9 describes the evidence-based wound care principles which should guide treatment
n The concluding statement identifies that further research is needed in order to determine best practice in skin tear prediction, prevention and assessment.
LeBlanc K, Baranoski S. Skin tears: state of the science: consensus statements for the prevention, prediction, assessment, and treatment of skin
tears.Adv Skin Wound Care 2011; Sep : 24(9 Suppl): 2–15.
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