J. Ferreira, M. Santos, Marcia A Souza, G. M. Silva, A. C. Monteiro, Hilda Yogui
Toxic epidermal necrolysis is a rare and severe skin reaction with a high mortality rate. This case report describes a case of toxic epidermal necrolysis in a 7-year-old patient caused by an adverse drug reaction.
{"title":"A Case Report: Toxic Epidermal Necrolysis in Children","authors":"J. Ferreira, M. Santos, Marcia A Souza, G. M. Silva, A. C. Monteiro, Hilda Yogui","doi":"10.35279/jewma201905.05","DOIUrl":"https://doi.org/10.35279/jewma201905.05","url":null,"abstract":"Toxic epidermal necrolysis is a rare and severe skin reaction with a\u0000high mortality rate. This case report describes a case of toxic epidermal\u0000necrolysis in a 7-year-old patient caused by an adverse drug reaction.","PeriodicalId":412636,"journal":{"name":"Journal of the European Wound Management Association","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125227684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Living with diabetic foot ulceration can have a significant impact on a person’s physical and psychological health. All members of the multidisciplinary team have a responsibility to consider the importance of wellbeing assessment and to be mindful of a number of suggested approaches.
{"title":"Optimising Wellbeing in Patients with Diabetic Foot Ulcers","authors":"C. Mcintosh, J. Ivory, G. Gethin, C. MacGilchrist","doi":"10.35279/jewma201905.02","DOIUrl":"https://doi.org/10.35279/jewma201905.02","url":null,"abstract":"Living with diabetic foot ulceration can have a significant impact on a person’s physical and psychological health. All members of the multidisciplinary team have a responsibility to consider the importance of wellbeing assessment and to be mindful of a number of suggested approaches.","PeriodicalId":412636,"journal":{"name":"Journal of the European Wound Management Association","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128046840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Radiotherapy is widely used to treat cancer, but it can influence the normal wound-healing process. Aim To present a narrative review of the current evidence related to the effects of radiotherapy on normal wound healing. Findings Fractionated radiotherapy treatment induces a repetitive cycle of inflammation. The acute effects of radiotherapy are mostly transient and are resolved within 4 weeks of the last dose, which correlates with the normal pathogenesis of skin regeneration. Two main theories exist with regards to the late effects of radiotherapy and the development of a chronic wound. One hypothesis is that there is a hypoxic–hypocellular–hypovascular effect. Other authors have argued that damage occurs as a result of changes to the microvasculature, in addition to the depletion of parenchymal and stromal cells. Conclusion: Recent evidence indicates that advances in treatment modalities, for example, the use of proton therapy and intensity-modulated radiotherapy, can positively influence patient outcomes in relation to tissue injury. Further advancements in our understanding of radiotherapy and its effects may lead to an improvement in the type of treatment modalities available, thereby helping prevent tissue injury altogether. Clinicians need to appreciate that healing of a radiation wound may not be realistic. Symptom-relieving treatment is of paramount importance to address the deleterious consequences of a radiotherapy related wound. Effects of radiotherapy on wound healing Clinicians also need to be cognisant of the need to maintain the patient’s self-esteem and maximise their quality of life. Key Messages This review explores the existing evidence related to the effects of radiotherapy on normal wound healing. The main observations from the studies examined indicate that ionising radiation damages cellular molecules primarily through strand breaks of deoxyribonucleic acid (DNA) or by the production of free radicals and reactive oxygen species, affecting both normal and tumour cells. Radiotherapy can impair the normal healing process in any phase of tissue repair as a result of cellular depletion, alteration in the extracellular matrix (ECM), and impairment of the microvasculature with subsequent tissue hypoxia. The acute effects of radiotherapy on the tissues range in severity from erythema to dry desquamation and hyperpigmentation. In the months or years following radiotherapy, tissue breakdown may occur leading to skin atrophy, dryness, telangiectasia, dyschromia, and dyspigmentation. INTRODUCTION Radiotherapy has been used as a treatment modality for over a century, and currently, it is used as a standalone cancer treatment or as an adjunct to surgery or chemotherapy.1 The two main types of radiotherapy are as follows: electromagnetic radiation with x-rays and gamma rays and particulate radiation using electrons, neutrons, and protons.2 Radiation is delivered through multiple modalities, with external beam being the most
{"title":"Effects of radiotherapy on wound healing","authors":"Pauline J. Robinson Rn, S. Holloway","doi":"10.35279/jewma201910.03","DOIUrl":"https://doi.org/10.35279/jewma201910.03","url":null,"abstract":"Background Radiotherapy is widely used to treat cancer, but it can influence the normal wound-healing process. Aim To present a narrative review of the current evidence related to the effects of radiotherapy on normal wound healing. Findings Fractionated radiotherapy treatment induces a repetitive cycle of inflammation. The acute effects of radiotherapy are mostly transient and are resolved within 4 weeks of the last dose, which correlates with the normal pathogenesis of skin regeneration. Two main theories exist with regards to the late effects of radiotherapy and the development of a chronic wound. One hypothesis is that there is a hypoxic–hypocellular–hypovascular effect. Other authors have argued that damage occurs as a result of changes to the microvasculature, in addition to the depletion of parenchymal and stromal cells. Conclusion: Recent evidence indicates that advances in treatment modalities, for example, the use of proton therapy and intensity-modulated radiotherapy, can positively influence patient outcomes in relation to tissue injury. Further advancements in our understanding of radiotherapy and its effects may lead to an improvement in the type of treatment modalities available, thereby helping prevent tissue injury altogether. Clinicians need to appreciate that healing of a radiation wound may not be realistic. Symptom-relieving treatment is of paramount importance to address the deleterious consequences of a radiotherapy related wound. Effects of radiotherapy on wound healing Clinicians also need to be cognisant of the need to maintain the patient’s self-esteem and maximise their quality of life. Key Messages This review explores the existing evidence related to the effects of radiotherapy on normal wound healing. The main observations from the studies examined indicate that ionising radiation damages cellular molecules primarily through strand breaks of deoxyribonucleic acid (DNA) or by the production of free radicals and reactive oxygen species, affecting both normal and tumour cells. Radiotherapy can impair the normal healing process in any phase of tissue repair as a result of cellular depletion, alteration in the extracellular matrix (ECM), and impairment of the microvasculature with subsequent tissue hypoxia. The acute effects of radiotherapy on the tissues range in severity from erythema to dry desquamation and hyperpigmentation. In the months or years following radiotherapy, tissue breakdown may occur leading to skin atrophy, dryness, telangiectasia, dyschromia, and dyspigmentation. INTRODUCTION Radiotherapy has been used as a treatment modality for over a century, and currently, it is used as a standalone cancer treatment or as an adjunct to surgery or chemotherapy.1 The two main types of radiotherapy are as follows: electromagnetic radiation with x-rays and gamma rays and particulate radiation using electrons, neutrons, and protons.2 Radiation is delivered through multiple modalities, with external beam being the most ","PeriodicalId":412636,"journal":{"name":"Journal of the European Wound Management Association","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116771687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Malignant fungating breast wounds, or malignant fungating wounds (MFWs) hereinafter, indicate a poor prognosis. For patients, malodour and copious exudate are the common distressing symptoms that require careful management. In addition to local wound management, patients require sensitive psychological support to improve their quality of life. Aim To review the current evidence on the psychological effects of MFWs. Findings In women with an MFW, feelings of anxiety associated with malodour and exudate were common, which affected their femininity and restricted their choice of clothing. In turn, this affected their body image and identity, in addition to creating a sense of social isolation, shame, and embarrassment. Moreover, the presence of an MFW served as a constant reminder of impending death, and the risk of bleeding was a major concern. Multiple studies have identified the positive influences of specialist and supportive care. Conclusion The evidence suggests that the main psychological aspects of an MFW in the breast are associated with the symptoms and visual nature of the wound, which act as a perpetual reminder of the person’s disease and mortality. The studies reviewed herein demonstrate how an MFW affects a woman’s femininity, body image, and self-esteem, leading to feelings of embarrassment, fear, and shame, and Correspondence: hollowaysl1@cf.ac.uk Conflicts of interest: None consequently, social isolation. The implications for clinical practice that emerged from the review highlight the importance of the management of wound malodour and exudate and also draw attention to the importance of access to specialist wound care support as these have been shown to have a positive effect on quality of life and mitigate some of the psychosocial effects of MFW. Key messages This review explored the psychological factors associated with an MFW of the breast. The results highlight that individuals with MFW experience low self-esteem the effects of which extend into many aspects of their daily lives, including their sex lives and social interactions. For many patients odour and exudate were the main contributing factors to feelings of shame and embarrassment, Furthermore for those individuals who experienced bleeding as a symptom of their wound reported being frightened of bleeding to death. A number of studies were able to show the positive effects of specialist wound care and counselling on the psychological wellbeing of the affected women. INTRODUCTION In the UK, 54,751 cases of breast cancer in the female population were reported in 2015.1 The incidence rates of breast cancer increase progressively from the ages of 30–34 years and more remarkably from the ages of 70–74 years.1 During 2016, 11,563 deaths occurred in relation to breast cancer, accounting for 7% of all cancer-related deaths, with mortality peaking at 90 plus years of age.1 Psychological factors associated with malignant fungating breast wounds Science, Practice and E
{"title":"Psychological factors associated with malignant fungating breast wounds","authors":"Pauline J. Robinson Rn, S. Holloway","doi":"10.35279/jewma201910.02","DOIUrl":"https://doi.org/10.35279/jewma201910.02","url":null,"abstract":"Background Malignant fungating breast wounds, or malignant fungating wounds (MFWs) hereinafter, indicate a poor prognosis. For patients, malodour and copious exudate are the common distressing symptoms that require careful management. In addition to local wound management, patients require sensitive psychological support to improve their quality of life. Aim To review the current evidence on the psychological effects of MFWs. Findings In women with an MFW, feelings of anxiety associated with malodour and exudate were common, which affected their femininity and restricted their choice of clothing. In turn, this affected their body image and identity, in addition to creating a sense of social isolation, shame, and embarrassment. Moreover, the presence of an MFW served as a constant reminder of impending death, and the risk of bleeding was a major concern. Multiple studies have identified the positive influences of specialist and supportive care. Conclusion The evidence suggests that the main psychological aspects of an MFW in the breast are associated with the symptoms and visual nature of the wound, which act as a perpetual reminder of the person’s disease and mortality. The studies reviewed herein demonstrate how an MFW affects a woman’s femininity, body image, and self-esteem, leading to feelings of embarrassment, fear, and shame, and Correspondence: hollowaysl1@cf.ac.uk Conflicts of interest: None consequently, social isolation. The implications for clinical practice that emerged from the review highlight the importance of the management of wound malodour and exudate and also draw attention to the importance of access to specialist wound care support as these have been shown to have a positive effect on quality of life and mitigate some of the psychosocial effects of MFW. Key messages This review explored the psychological factors associated with an MFW of the breast. The results highlight that individuals with MFW experience low self-esteem the effects of which extend into many aspects of their daily lives, including their sex lives and social interactions. For many patients odour and exudate were the main contributing factors to feelings of shame and embarrassment, Furthermore for those individuals who experienced bleeding as a symptom of their wound reported being frightened of bleeding to death. A number of studies were able to show the positive effects of specialist wound care and counselling on the psychological wellbeing of the affected women. INTRODUCTION In the UK, 54,751 cases of breast cancer in the female population were reported in 2015.1 The incidence rates of breast cancer increase progressively from the ages of 30–34 years and more remarkably from the ages of 70–74 years.1 During 2016, 11,563 deaths occurred in relation to breast cancer, accounting for 7% of all cancer-related deaths, with mortality peaking at 90 plus years of age.1 Psychological factors associated with malignant fungating breast wounds Science, Practice and E","PeriodicalId":412636,"journal":{"name":"Journal of the European Wound Management Association","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128301004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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