&lt;p&gt;Atypical Ulcers: Diagnosis and Management&lt;/p&gt;

Janowska, Agata; Dini, Valentina; Oranges, Teresa; Iannone, Michela; Loggini, Barbara; Romanelli, Marco

doi:10.2147/cia.s231896

Cited by 31 publications

(25 citation statements)

References 41 publications

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“… 5 Chronic wounds may have different aetiologies and are commonly classified in the categories of diabetic foot ulcers (DFUs), wounds related to peripheral arterial disease, venous leg ulcers, pressure injuries (PIs), 6 and atypical hard‐to‐heal wounds (AHHW). 7 , 8 Healing of chronic wounds depends on several complex biological factors and wound care regimens. 9 , 10 However, even after a chronic wound heals up to 40% of DFUs 11 and 69% of venous leg ulcers 12 may recur within 1 year.…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross‐sectional study in Singapore

Zhu

Olsson

Bajpai

et al. 2021

International Wound Journal

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Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age ( β = 0.008, P < .001), non‐Chinese ethnicity ( β = 0.25, P = .001), mixed ulcers ( β = −0.41, P = .022), atypical hard‐to‐heal wounds ( β = −0.38, P = .021), wounds with low ( β = 0.24, P = .044) to moderate ( β = 0.29, P = .018) exudate level, and a wound duration ≥6 months ( β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.

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Section: Introductionmentioning

confidence: 99%

Health‐related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross‐sectional study in Singapore

Zhu

Olsson

Bajpai

et al. 2021

International Wound Journal

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“…TIME facilitates a correct wound bed preparation reducing edema, exudate and the bacterial burden 26 . A specific TIME has been proposed for the management of few conditions, as hidradenitis suppurativa and atypical ulcers in general 27,28 . During the inflammatory phase, the therapy aims to control the inflammation on the perilesional skin and on the wound bed.…”

Section: Discussionmentioning

confidence: 99%

PG‐TIME : A practical approach to the clinical management of pyoderma gangrenosum

Janowska

Oranges

Fissi

et al. 2020

Dermatologic Therapy

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Pyoderma gangrenosum (PG) is a neutrophilic dermatosis which may be rapidly progressive. Standard guidelines for local treatment are lacking. Through our experience, we suggested a local treatment algorithm based on the tissue, infection, moisture balance, and epithelization (TIME) concept. The clinical and histopathological features of 52 patients with PG, the duration, and the evolution of the lesions were retrospectively evaluated. Systemic therapies, local treatments, and standard wound treatments were reported. We observed ulcerative PG in the majority of the patients (82.6%), followed by the pustular form (9.6%), the peristomal type (3.8%), the vegetative form (1.9%), and the bullous type (1.9%). The lower leg was the most commonly area affected (90.4% of cases). Pathergy was reported in 15.3% of cases. The first‐line treatment was the use of oral glucocorticosteroids (GCSs). We observed healing after 3 weeks of GCS in 17.3% of cases. In 25% of all cases, we obtained complete healing with long‐term low doses (<0.5 mg/kg) of GCS in the range of 2 to 6 months. We used second‐line treatments in 57.6% of patients. Local, systemic treatment, and correct wound management can be associated with better clinical results. We suggest a new local therapeutic algorithm in both the inflammatory and noninflammatory healing phases.

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“…Lower limb skin defects are very common in plastic surgeons’ practice and can result from a wide range of aetiologies including the so-called typical ulcers (venous insufficiency, arterial insufficiency, neuropathy, diabetes and external pressure on body prominences) and the atypical ulcers (caused by inflammatory, neoplastic, vasculopathic, hematological, infectious and drug-induced aetiologies) in which the diagnosis may be difficult and often delayed [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

One-Stage Coverage of Leg Region Defects with STSG Combined with VAC Dressing Improves Early Patient Mobilisation and Graft Take: A Comparative Study

Sapino

Lanz

Roesti

et al. 2022

JCM

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Lower limb skin defects are very common and can result from a wide range of aetiologies. Split thickness skin graft (STSG) is a widely used method to address these problems. The role of postoperative dressing is primary as it permits one to apply a uniform pressure over the grafted area and promote adherence. Focusing on lower limb reconstruction, our clinical study compares the application of V.A.C. (Vacuum Assisted Closure) Therapy vs. conventional dressing in the immediate postoperative period following skin grafting. We included in the study all patients who received skin grafts on the leg region between January 2015 and December 2018, despite the aetiology of the defect. Only reconstructions with complete preoperative and postoperative follow-up data were included in the study. Patients were divided into two groups depending on if they received a traditional compressive dressing or a VAC dressing in the immediate postoperative period. We could retain 92 patients, 23 in the No VAC group and 69 in the VAC group. The patients included in the VAC group showed a statistically significant higher rate of graft take together with a lower immobilisation time (p < 0.05). Moreover, a lower rate of postoperative infection was recorded in the VAC group. This study represents the largest in the literature to report in detail surgical outcomes comparing the use of VAC therapy vs. conventional dressing after STSG in the postoperative management of lower limb reconstruction using skin grafts. VAC therapy was used to secure the grafts in the leg region, increasing the early graft take rate while at the same time improving patient mobilisation.

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<p>Atypical Ulcers: Diagnosis and Management</p>

Cited by 31 publications

References 41 publications

Health‐related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross‐sectional study in Singapore

Health‐related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross‐sectional study in Singapore

PG‐TIME : A practical approach to the clinical management of pyoderma gangrenosum

One-Stage Coverage of Leg Region Defects with STSG Combined with VAC Dressing Improves Early Patient Mobilisation and Graft Take: A Comparative Study

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