The journal of the American College of Clinical Wound Specialists最新文献

A 59-year-old African American female presented to a plastic surgery office in consultation for a very painful non-healing wound of her right lateral malleolus. An incisional biopsy was performed and ultimately a diagnosis of hydroxyurea-induced ulcer was concluded. Descriptions of this entity are rare in the surgical and wound care professional literature. This diagnosis does appear in the hematology/oncology literature; however, these practitioners may not be the first to examine a patient with the development of such an ulcer. This article presents the pathophysiology and clinical presentation of hydroxyurea-induced ulceration as well as the characteristics of hydroxyurea-induced ulceration in addition to the case study.

Biologically engineered products are medical devices offer support and structure for wound healing by providing a scaffold for cell growth and proliferation. In the field of plastic surgery, these devices are being used to improve the outcomes of surgical closure in selected patients. The purpose of this article is to provide an overview of the source, indications, mechanisms, and outcomes of commonly used biologic products in wound healing. It will also provide an understanding of how biologics can be of value to patients with significant tissue defects requiring plastic surgery.

Eosinophilic granulomatosis (EGPA), or Churg-Strauss syndrome, is a rare and necrotizing systemic vasculitis, which affects small-to-medium-sized vessels and often manifests with severe asthma and eosinophilia. We report a case of a 72 year-old male with a two-year lung-biopsy proven history of EGPA who presented with retiform purpura and patchy necrosis on his bilateral shins, which progressed to sharply demarcated, stellate ulcerations with surrounding erythema within two weeks. Laboratory work up revealed elevated anti-Cardiolipin IgM, rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein, although P-neutrophil cytoplasmic antibody (P-ANCA) and C-neutrophil cytoplasmic antibody (C-ANCA) were negative. Vascular studies revealed long anterior tibial and dorsalis pedis artery occlusion and severe small vessel disease in plantar digital arteries. Despite treatment with intravenous cyclophosphamide, pulse-dose methylprednisolone, and pentoxifylline, the patient experienced disease progression and limb threatening arterial thrombosis. This case highlights the importance of vascular and neuropathic sequelae that may result from untreated or undertreated EGPA in P-ANCA-negative patients without active pulmonary symptoms.

Pyogenic granuloma (PG) is a common, acquired, benign vascular reactive proliferation. This article presents the unique and successful pulsed dye laser treatment of a labial PG on a 60-year-old patient.

Pressure injuries increase morbidity and mortality in geriatric patients by 400%. Residents in long-term care (LTC) are at high risk of developing pressure injuries because of limited mobility, poor nutritional status, impaired cognition, and incontinence. This study aims to determine whether a no-sting barrier film (NSBF) treatment protocol is more effective than current physician practices for treating stage 1 and 2 pressure injuries in LTC. A retrospective cohort study of 129 residents from one LTC facility was performed after a six-month implementation trial of a NSBF treatment protocol. The six-month incidence rate of stage 1 and 2 pressure injuries was 9% and 38% respectively. There was a statistically significant reduction in healing time in those treated with the NSBF protocol. In summary, the NSBF protocol reduces healing time of stage 1 and 2 pressure injuries; this protocol could be easily incorporated into existing pressure injury treatment strategies in LTC.