Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000135
Vishal Garimella, Nimay Anand, Elliott H Campbell, Christian L Baum, Afsaneh Alavi
When angiosarcoma, a rare and aggressive tumor of the soft tissue, develops in the setting of chronic lymphedema, it is referred to as Stewart-Treves syndrome. It is usually seen in chronic lymphedema of the upper limbs postmastectomy. Angiosarcoma developing in the lower limb in the setting of chronic lymphedema is rare and has a poor outcome. The presentation of angiosarcoma can vary, ranging from a bleeding papule to a plaque or a subcutaneous mass, which can later progress to ulceration or necrosis. Treatment for Stewart-Treves syndrome is aggressive because of its poor prognosis and usually requires a multidisciplinary approach of surgery, radiation, and chemotherapy. Several theories have been put forth to explain the mechanism of Stewart-Treves syndrome, but it remains ambiguous. The current literature regarding angiosarcoma developing in the setting of chronic lymphedema in the lower limb is limited to single case reports. Herein, the authors report a series of six cases of biopsy-proven angiosarcoma in the setting of lower extremity lymphedema. Providers should include angiosarcoma in the differential diagnosis of ulcerative or vascular tumors arising in the context of lower extremity lymphedema.
{"title":"Lower Extremity Angiosarcoma: A Life-Threatening Complication of Lymphedema.","authors":"Vishal Garimella, Nimay Anand, Elliott H Campbell, Christian L Baum, Afsaneh Alavi","doi":"10.1097/asw.0000000000000135","DOIUrl":"https://doi.org/10.1097/asw.0000000000000135","url":null,"abstract":"When angiosarcoma, a rare and aggressive tumor of the soft tissue, develops in the setting of chronic lymphedema, it is referred to as Stewart-Treves syndrome. It is usually seen in chronic lymphedema of the upper limbs postmastectomy. Angiosarcoma developing in the lower limb in the setting of chronic lymphedema is rare and has a poor outcome. The presentation of angiosarcoma can vary, ranging from a bleeding papule to a plaque or a subcutaneous mass, which can later progress to ulceration or necrosis. Treatment for Stewart-Treves syndrome is aggressive because of its poor prognosis and usually requires a multidisciplinary approach of surgery, radiation, and chemotherapy. Several theories have been put forth to explain the mechanism of Stewart-Treves syndrome, but it remains ambiguous. The current literature regarding angiosarcoma developing in the setting of chronic lymphedema in the lower limb is limited to single case reports. Herein, the authors report a series of six cases of biopsy-proven angiosarcoma in the setting of lower extremity lymphedema. Providers should include angiosarcoma in the differential diagnosis of ulcerative or vascular tumors arising in the context of lower extremity lymphedema.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000143
Dilek Yilmaz Akyaz, Tugba Cevizci, Tuba Sengul
To investigate the effect of daily versus weekly comprehensive skin assessments on wound healing status in patients with pressure injuries (PIs) treated in the general ICU.
{"title":"Everyday Prevention: The Impact of Daily Comprehensive Skin Assessments on Pressure Injury Healing in the General ICU.","authors":"Dilek Yilmaz Akyaz, Tugba Cevizci, Tuba Sengul","doi":"10.1097/asw.0000000000000143","DOIUrl":"https://doi.org/10.1097/asw.0000000000000143","url":null,"abstract":"To investigate the effect of daily versus weekly comprehensive skin assessments on wound healing status in patients with pressure injuries (PIs) treated in the general ICU.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000129
Alessandra Michelucci, Flavia Manzo Margiotta, Giammarco Granieri, Giorgia Salvia, Cristian Fidanzi, Matteo Bevilacqua, Salvatore Panduri, Marco Romanelli, Valentina Dini
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is challenging to diagnose and treat. Clinicians frequently use fast-acting corticosteroids, which are subsequently combined with slower-acting immunosuppressants to progressively taper the corticosteroid dosage. Current research is focused on the use of monoclonal antibodies (mAbs) directed against target molecules involved in the pathogenesis of PG. However, available data on their efficacy are based on sporadic case reports and clinical experiences, so the authors aimed to evaluate the efficacy of risankizumab, an anti-interleukin-23 mAb, in the management of two complex PG cases. The authors enrolled two patients with PG who were already treated with immunosuppressive therapies. Their management was based on the off-label use of an mAb directed against the p19 subunit of interleukin-23: risankizumab. Patients received subcutaneous injections of 150 mg at the start of treatment, at week 4, and then every 10 weeks thereafter. Systemic therapy was combined with local management of ulcers, based on the principles of TIME (tissue, infection, moisture balance, and epithelialization) applied to the inflammatory and noninflammatory phases of PG. Clinical resolution was obtained at week 24 for patient 1 and week 16 for patient 2 and was maintained until week 40, without adverse effects or disease recurrence. These clinical cases demonstrate that risankizumab is a valid tool in terms of efficacy and safety for complicated cases of multirefractory PG when provided in parallel with local personalized wound management.
{"title":"Risankizumab as a Therapeutic Approach for Recalcitrant Pyoderma Gangrenosum.","authors":"Alessandra Michelucci, Flavia Manzo Margiotta, Giammarco Granieri, Giorgia Salvia, Cristian Fidanzi, Matteo Bevilacqua, Salvatore Panduri, Marco Romanelli, Valentina Dini","doi":"10.1097/asw.0000000000000129","DOIUrl":"https://doi.org/10.1097/asw.0000000000000129","url":null,"abstract":"Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is challenging to diagnose and treat. Clinicians frequently use fast-acting corticosteroids, which are subsequently combined with slower-acting immunosuppressants to progressively taper the corticosteroid dosage. Current research is focused on the use of monoclonal antibodies (mAbs) directed against target molecules involved in the pathogenesis of PG. However, available data on their efficacy are based on sporadic case reports and clinical experiences, so the authors aimed to evaluate the efficacy of risankizumab, an anti-interleukin-23 mAb, in the management of two complex PG cases. The authors enrolled two patients with PG who were already treated with immunosuppressive therapies. Their management was based on the off-label use of an mAb directed against the p19 subunit of interleukin-23: risankizumab. Patients received subcutaneous injections of 150 mg at the start of treatment, at week 4, and then every 10 weeks thereafter. Systemic therapy was combined with local management of ulcers, based on the principles of TIME (tissue, infection, moisture balance, and epithelialization) applied to the inflammatory and noninflammatory phases of PG. Clinical resolution was obtained at week 24 for patient 1 and week 16 for patient 2 and was maintained until week 40, without adverse effects or disease recurrence. These clinical cases demonstrate that risankizumab is a valid tool in terms of efficacy and safety for complicated cases of multirefractory PG when provided in parallel with local personalized wound management.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000127
Aria Appoo, Brandon L Christensen, Ranjani Somayaji
To review how different classes of immunosuppressants affect wound healing.
回顾不同类别的免疫抑制剂如何影响伤口愈合。
{"title":"Examining the Association between Immunosuppressants and Wound Healing: A Narrative Review.","authors":"Aria Appoo, Brandon L Christensen, Ranjani Somayaji","doi":"10.1097/asw.0000000000000127","DOIUrl":"https://doi.org/10.1097/asw.0000000000000127","url":null,"abstract":"To review how different classes of immunosuppressants affect wound healing.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000141
Sol Tejeda Ramírez, Aroa Tardáguila-García, Mateo López-Moral, Irene Sanz-Corbalán, Marta García-Madrid, José Luis Lázaro-Martínez
To evaluate the cost-effectiveness of two 10% urea creams in patients with diabetic foot syndrome.
评估糖尿病足综合征患者使用两种 10%尿素软膏的成本效益。
{"title":"Randomized Double-blind Cost-effectiveness Comparison of Two 10% Urea Creams in Patients with Diabetic Foot Syndrome.","authors":"Sol Tejeda Ramírez, Aroa Tardáguila-García, Mateo López-Moral, Irene Sanz-Corbalán, Marta García-Madrid, José Luis Lázaro-Martínez","doi":"10.1097/asw.0000000000000141","DOIUrl":"https://doi.org/10.1097/asw.0000000000000141","url":null,"abstract":"To evaluate the cost-effectiveness of two 10% urea creams in patients with diabetic foot syndrome.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000131
Xinyan Du, Xuena Zhang, Junxia Liu, Zhendi Wang
To synthesize the effects of oxygen-based therapy on patients with a chronic wound.
总结氧气疗法对慢性伤口患者的影响。
{"title":"Effects of Oxygen Therapy on Patients with a Chronic Wound: A Systematic Review and Meta-analysis.","authors":"Xinyan Du, Xuena Zhang, Junxia Liu, Zhendi Wang","doi":"10.1097/asw.0000000000000131","DOIUrl":"https://doi.org/10.1097/asw.0000000000000131","url":null,"abstract":"To synthesize the effects of oxygen-based therapy on patients with a chronic wound.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140636475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000137
Hélio Galdino-Júnior, Emilson Martins de Oliveira Segundo, Suelen Gomes Malaquias, Marina Clare Vinaud, Lilian Varanda Pereira, Rafael Alves Guimarães, Maria Márcia Bachion
To evaluate the use of heated saline solution during wound cleaning on the intensity of pain related to the procedure, the temperature of the wound bed, and the comfort of patients with chronic wounds. Further, to investigate patient preference in relation to the temperature of the solution used for cleaning.
{"title":"Effect of Heated Saline Solution on Pain Intensity, Wound Bed Temperature, and Comfort during Chronic Wound Dressing Changes: Crossover Randomized Clinical Trial.","authors":"Hélio Galdino-Júnior, Emilson Martins de Oliveira Segundo, Suelen Gomes Malaquias, Marina Clare Vinaud, Lilian Varanda Pereira, Rafael Alves Guimarães, Maria Márcia Bachion","doi":"10.1097/asw.0000000000000137","DOIUrl":"https://doi.org/10.1097/asw.0000000000000137","url":null,"abstract":"To evaluate the use of heated saline solution during wound cleaning on the intensity of pain related to the procedure, the temperature of the wound bed, and the comfort of patients with chronic wounds. Further, to investigate patient preference in relation to the temperature of the solution used for cleaning.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the mediating effect of self-efficacy and coping mode between powerlessness and quality of life in patients with a venous leg ulcer (VLU).
探讨自我效能感和应对模式在静脉性腿部溃疡（VLU）患者的无力感和生活质量之间的中介效应。
{"title":"The Mediating Role of Self-efficacy and Coping Mode Between Powerlessness and Quality of Life in Patients with Venous Leg Ulcers.","authors":"Hui Shan, Qi Li, Xiaoqing Xu, Xiaoying Wang, Jing Han, Ju Zhang","doi":"10.1097/asw.0000000000000142","DOIUrl":"https://doi.org/10.1097/asw.0000000000000142","url":null,"abstract":"To explore the mediating effect of self-efficacy and coping mode between powerlessness and quality of life in patients with a venous leg ulcer (VLU).","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1097/asw.0000000000000136
James B Stiehl
This case report reviews the effect of combining a 250-cc bottle of standard antimicrobial, buffered sodium hypochlorite with a surgical method, low-pressure jet lavage irrigation in the outpatient setting to control difficult wound contamination. A 73-year-old man had been in treatment for over 8 years, undergoing at least 18 surgical wound debridement procedures for an extensive undermined pelvic pressure injury involving the sacrum, ischium, and greater trochanter. Cultures and polymerase chain reaction diagnostics revealed a multibacterial presence. Autofluorescent imaging (AFI) was used in 21 examinations performed after a 72-hour delay over a long weekend. The AFI contamination exceeded log 4 colony-forming units/g of tissue in all pretreatment examinations and was reduced to less than log 2 colony-forming units in 6 of 21 examinations, with the remaining 15 showing an estimated 80% or higher removal of the bacterial porphyrin "red" appearance. A total of 54 AFI examinations were performed using the combination treatment, and no adverse reactions were encountered. Treatment paradigms can be improved with a multifactorial approach.
{"title":"Bacterial Contamination Control with Sodium Hypochlorite and Jet Lavage Irrigation in a Severe Stage 4 Pelvic Pressure Injury: A Case Report.","authors":"James B Stiehl","doi":"10.1097/asw.0000000000000136","DOIUrl":"https://doi.org/10.1097/asw.0000000000000136","url":null,"abstract":"This case report reviews the effect of combining a 250-cc bottle of standard antimicrobial, buffered sodium hypochlorite with a surgical method, low-pressure jet lavage irrigation in the outpatient setting to control difficult wound contamination. A 73-year-old man had been in treatment for over 8 years, undergoing at least 18 surgical wound debridement procedures for an extensive undermined pelvic pressure injury involving the sacrum, ischium, and greater trochanter. Cultures and polymerase chain reaction diagnostics revealed a multibacterial presence. Autofluorescent imaging (AFI) was used in 21 examinations performed after a 72-hour delay over a long weekend. The AFI contamination exceeded log 4 colony-forming units/g of tissue in all pretreatment examinations and was reduced to less than log 2 colony-forming units in 6 of 21 examinations, with the remaining 15 showing an estimated 80% or higher removal of the bacterial porphyrin \"red\" appearance. A total of 54 AFI examinations were performed using the combination treatment, and no adverse reactions were encountered. Treatment paradigms can be improved with a multifactorial approach.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/asw.0000000000000123
SooA Lim, Dong Yun Lee, GyeongHyeon Doh, YeongKwon Seo, ChiYeon Lim, JungSoo Yoon, SuRak Eo
To evaluate the strengths of various surgical knot techniques, including square knot, surgeon's knot, granny knot, and random knot with the same three throws.
{"title":"Security Comparison of Various Surgical Knots Using Nylon Suture.","authors":"SooA Lim, Dong Yun Lee, GyeongHyeon Doh, YeongKwon Seo, ChiYeon Lim, JungSoo Yoon, SuRak Eo","doi":"10.1097/asw.0000000000000123","DOIUrl":"https://doi.org/10.1097/asw.0000000000000123","url":null,"abstract":"To evaluate the strengths of various surgical knot techniques, including square knot, surgeon's knot, granny knot, and random knot with the same three throws.","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140593405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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