Schmerzreduktion bei Patienten mit chronischem Ulcus cruris durch ein neu entwickeltes Morphingel

Huptas, Lisa; Rompoti, Natalia; Herbig, S.; Körber, Andreas; Klode, Joachim; Schadendorf, Dirk; Dissemond, Joachim

doi:10.1007/s00105-011-2141-x

Cited by 31 publications

(18 citation statements)

References 24 publications

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“…In addition, an adequate pain therapy is necessary, because all patients in our group described their ulcerations as very painful. Besides non-steroidal anti-inflammatory drugs and opioids, a topical pain therapy with morphinecontaining hydrogel can reduce the pain significantly (31). In most of our cases, a therapy with topical glucocorticosteroids was started as an initial treatment and then intralesional injections of glucocorticosteroids were tried.…”

Section: Treatmentmentioning

confidence: 96%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated.

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Section: Treatmentmentioning

confidence: 96%

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Franklin

Stoffels-Weindorf

Hillen

et al. 2013

International Wound Journal

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“…Die topische Therapie der Wunden erfolgte mit einem polihexanidhaltigen Morphingel [3]; die Wundumgebung wurde 2-mal täglich mit 0,1% TacrolimusSalbe behandelt. Zudem erfolgte die Einleitung einer systemischen Glukokortikoidtherapie mit 70 mg Prednisolon.…”

Section: Therapie Und Verlaufunclassified

Multilokuläres Pyoderma gangraenosum nach Uterusresektion

Ghazal

Dissemond

2012

Chirurg

Self Cite

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A 71-year-old patient presented with very painful ulcers after uterus-resection with the da Vinci® Surgical System 3 months before. The anamnesis revealed that in the past 10 months similar wounds had appeared after osteosynthesis of a humerus fracture and after breast biopsy. The patient had been unsuccessfully treated with different antibiotics and wound dressings for several months for a suspected superinfected, postoperative disturbed wound healing. None of the wounds became smaller or healed completely. After exclusion of relevant differential diagnoses pyoderma gangrenosum (PG) could be diagnosed and systemic immunosuppressive therapy was initiated. The pain improved rapidly and complete wound healing was achieved. Pyoderma gangrenosum is a rarely diagnosed autoimmune disease which often occurs after physical trauma such as surgical interventions. Because a correct diagnose is usually made late it is important to be aware of this disease to treat it early and correctly.

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“…The use of diamorphine 10mg added to amorphous hydrogel, applied directly on the lesion, controlled the pain in the first day of the treatment [22,25]. The topical application of morphine sulfate 10 mg/ml in 8 g of hydrogel in 16 patients with malignant wound revealed that the experimental group had pain relief in comparison with the control group [26]. The use of morphine gel with polyhexanide (PHMB) in 30 patients with painful chronic leg ulcers resulted in pain relief in all patients.…”

Section: N3mentioning

confidence: 99%

Malignant Neoplastic Wounds: Clinical Management Performed by Nurses

et al. 2016

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Objective: Investigate the clinical management of patients with neoplastic wounds by nurses.Methods: This is an exploratory study, with qualitative approach, conducted in August 2014, with ten clinical nurses of a philanthropic hospital that provides care to patients with advanced cancer. Data were collected through semi-structured interviews and data analysis was performed using the Minayo's Thematic Analysis Technique, which enabled the construction of one category and four subcategories. Results:The nurses' knowledge on the clinical management of wounds is weak and has many weaknesses involving patients with advanced cancer. Conclusion:One evidenced the need to invest in continuing education and implementation of protocols that support greater autonomy of nurses in decision-making, ensuring legal support to these professionals to improve care for people with neoplastic wounds.

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Schmerzreduktion bei Patienten mit chronischem Ulcus cruris durch ein neu entwickeltes Morphingel

Cited by 31 publications

References 24 publications

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients

Multilokuläres Pyoderma gangraenosum nach Uterusresektion

Malignant Neoplastic Wounds: Clinical Management Performed by Nurses

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