New articles published by the Journal of Wound Management

   

 

This article should be referenced as: Zaya JJT, Conde-Montero E,  Marín LR, Jerónimo LP, Vázquez AP, Pérez AC, Dobao PC: Comorbidities and clinical features of Martorell hypertensive ischemic leg ulcers: findings from a retrospective cohort study, Journal of Wound Management, 2021

 

Abstract

Background: Ischaemic wounds are notoriously difficult to treat, as poor perfusion often leads to chronic, non-healing wounds.

Aim: This case study describes the successful treatment of an ischemic ulceration in a neonate using topical oxygen therapy (TOT).

Methods: A large necrotic ulceration quickly developed over the left gluteal area in a 2-week-old child and enlarged to cover the entire gluteal area in one week. The aetiology of the wound was ischaemic, due to internal iliac artery thrombosis after an umbilical vein catheterisation. The wound was initially managed using the standard of care and surgical debridement of the necrotic tissue with saline dressing; however, the condition worsened with the development of a new necrotic patch. Topical oxygen therapy (TOT) was applied using the M.O.I.S.T. concept. After the second surgical debridement, TOT in the form of haemoglobin spray was administered on alternate days and a moist dressing was applied.

Results / Findings: The wound healed progressively, with granulation tissue formation and epithelisation after 6 weeks.

Conclusions: Wound management in neonates is extremely challenging, due to their relatively small physical size and the preference for less invasive management strategies.

Implications for clinical practice: TOT has proven to be an easily accessible, efficacious, non-invasive and cost-effective method for treating ischaemic wounds in neonates.

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Leiomyosarcoma - A rare neoplasia arising from a chronic venous ulcer. Case report and literature review

Authors: Ion A, Giurcaneanu C, Nichita M, Orzan OA, Popa LG, Beiu C, Tudose I, Mihai MM

DOI: 10.35279/jowm202104.06

First published 19 April 2021

  

 

This article should be referred as: Ion A, Giurcaneanu C, Nichita M, Orzan OA, Popa LG, Beiu C, Tudose I, Mihai MM: Leiomyosarcoma - A rare neoplasia arising from a chronic venous ulcer. Case report and literature review, Journal of Wound Management, 2021

 

Abstract

Background: Long-standing wounds are at risk of developing malignant degeneration, including leiomyosarcomas. These exceedingly rare malignant tumours originate from smooth muscle cells and are considered superficial if they affect the dermis and/or subcutis.

Hypothesis: To exclude malignancy, a biopsy should be performed on chronic skin ulcers with atypical features or evolutions.

Methods: We report the case of a 62-year-old male with a history of a two-year old chronic venous ulcer who presented
with a tumour developing over three months, progressively increasing in size on the surface of the wound. As the clinical aspect strongly suggested a malignant tumour arising within a chronic venous ulcer (the initial suspicion was of squamous cell carcinoma), a biopsy from the edge of the lesion was performed.

Results: Histopathological and immunohistochemical examinations revealed a diagnosis of leiomyosarcoma.
The patient refused further medical care. The tumour arose in the context of severe cutaneous changes of venous insufficiency and had aggressive clinical behaviour.
Histopathological and immunohistochemical analysis of the tissue sample is essential for establishing the final diagnosis, as no pathognomonic clinical features of leiomyosarcoma exist.
Conclusions: Our case emphasises the importance of considering malignancy in chronic ulcers with atypical features or evolution. Biopsy of atypical skin ulcers is crucial for establishing a diagnosis and initiating therapy at the rightful moment.

Implications for clinical practice: The findings from this case highlight the importance of an early diagnosis of atypical, non-healing wounds, based on tissue samples, to decide the optimal approach. Patient denial may interfere with the proper management of this particular clinical context.

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Comorbidities and clinical features of Martorell hypertensive ischemic leg ulcers: findings from a retrospective cohort study

Authors: Juan José Téllez Zaya, Elena Conde-Montero, Lorena Recarte Marín, Laura Pérez Jerónimo, Alicia Peral Vázquez, Alba Casillas Pérez, Pablo de la Cueva Dobao

DOI: 10.35279/jowm202104.04

First published 9 April 2021

  

 

This article should be referenced as: Zaya JJT, Conde-Montero E,  Marín LR, Jerónimo LP, Vázquez AP, Pérez AC, Dobao PC: Comorbidities and clinical features of Martorell hypertensive ischemic leg ulcers: findings from a retrospective cohort study, Journal of Wound Management, 2021

 

Abstract

Background: Martorell hypertensive ischemic leg ulcers are commonly misdiagnosed, and their prevalence may be underestimated. There are still some aspects to be defined about the aetiopathogenesis of Martorell ulcers and the risk factors that may be involved with them.

Methods: This is a single-centre retrospective case series study on the demographic characteristics and comorbidities in a series of patients with Martorell ulcer treated at a public university hospital in Madrid.

Results: Comparing our results to previous studies, which are few and include small samples, the risk factors that we outline are an average age over 70 years and high blood pressure. Only two (5%) participants had poor control of their high blood pressure.

Conclusions and Implications for Clinical Practice: Defining the epidemiological features of this type of leg ulcer may be very useful in differential diagnosis with other disorders, such as pyoderma gangrenosum.

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Patients’ perceptions of, and acceptance toward, using wearable sensor technology in wound care

Megan R. Goldrick, BSc, MSc, Georgina T. Gethin, PhD, MSc, PG, RGN, FFNM RCSI

DOI: 10.35279/jowm202104.03

First published 29 March 2021

   

 

This article should be referenced as: Goldrick MR, Gethin GT: Patients’ perceptions of, and acceptance toward, using wearable sensor technology in wound care, Journal of Wound Management, 2021

 

Abstract

Background: Wearable sensor technologies for wound management have slowly found their way into healthcare systems worldwide. They aim to produce benefits in the reduction of hospitalisation time, facilitate home healthcare, mitigate loses incurred by human error, reductions in clinician and nursing efforts and the prevention of amputations. They have the ability to capture the diurnal and circadian variations of wound parameters, with patients benefitting from continuous long-term monitoring as a part of either a diagnostic procedure or the maintenance of their wounds.

Aim: This study explored the perceptions of those living with chronic wounds of the foot and lower limb toward the concept of a wearable sensor technology for wound management.
Methods: A qualitative description method was employed. Twenty-three semi-structured interviews were conducted in three geographically distinct locations in Ireland. A thematic analysis was also conducted.

Results: Four main themes emerged: the element of personal contact, the medical need for wound diagnostics, the practicalities of wearable sensor devices and the trialable nature of wearable sensor devices.

Conclusions: Most participants indicated feelings of concern toward accepting wearable sensor technology as a part of wound management and the potential loss of contact with their attending clinician. These findings contribute to understanding technology acceptance.

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This article should be referenced as: Hussein A, Gershater MA: The diabetic foot in hospitalised stroke patients: Documentation of nursing actions and the need for improvement, Journal of Wound Management, 2021

 

Abstract

Background: Patients with diabetes and stroke have a high risk of injury to the paralysed side of the body, but are incapacitated and unable to maintain their self-care. In stroke units, registered nurses can assist patients through systematic assessments and nursing interventions, including preventive footcare.

Aim: To explore the documentation of preventive nursing actions regarding the risk of developing foot ulcers in patients with diabetes and stroke at a neurology clinic’s inpatient ward.

Method: A retrospective systematic review of computerised nursing records using the Global Trigger Tool (GTT). All records (n = 101) of patients with diabetes and stroke at the clinic between 1 January and 20 December 2015 were assessed. Descriptive statistics and manifest content analysis were used.

Results: Median age: 78 years (41–93). Male/Female: n = 61/40. The records revealed insufficient documentation: Risk for foot ulcers was not documented in any of the records. The GTT showed that three patients had a documented foot ulcer, all with localisation on the same side in which the patient was paralysed. Documented nursing actions for foot ulcer prevention in bed were provided for 12 patients, but none were provided for patients sitting in a chair. Risk factors, according to the International Working Group of the Diabetic Foot, were found in 12 of the patients’ records. The nursing process was not mentioned in the records.

Conclusion: Insufficient documentation indicates that the patients’ feet are not assessed and protected.

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