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Shawa H, Wu PA, Dahle S, Isseroff RR, Sood A. Potential Allergens in Wound Care Products. Dermatitis 2023; 34:51-55. [PMID: 36705648 DOI: 10.1089/derm.0000000000000946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Patients with chronic wounds have an increased risk of developing allergic contact dermatitis (ACD). Reports of ACD to wound care products are not uncommon. To minimize contact sensitization in patients with chronic wounds, allergenic ingredients should be avoided when possible. Objective: With more than 5000 wound care products available in the United States, it is essential to understand which products can be chosen to minimize allergen exposures. Methods: Ingredients in wound care products in 5 wound care clinics across 2 institutions were cross-referenced with the American Contact Dermatitis Society core allergen series 2020. Results: Of the 267 wound care products included, 97 (36.3%) contained at least one allergen, including 31 dressings/wraps (22.3%), 25 medications (69.4%), 12 cleaning supplies (36.3%), 16 tapes/glues (80%), 2 instruments (14.3%), 8 emollients and vehicles (61.5%), 1 ostomy product (11.1%), and 2 odor-eliminating products (66.7%). Thirty-four different allergens were identified across all products. The most common allergens present in the included items were acrylates and propylene glycol, followed by parabens, cetyl stearyl alcohol, tocopherol, fragrance, and phenoxyethanol. Conclusions: Many wound care products contain at least one contact allergen, highlighting the importance of clinician education on ACD in the context of wound care product selection.
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Affiliation(s)
- Harrison Shawa
- From the ∗Department of Dermatology, University of California, Davis.,Section of Dermatology
| | - Peggy A Wu
- From the ∗Department of Dermatology, University of California, Davis.,Section of Dermatology
| | - Sara Dahle
- From the ∗Department of Dermatology, University of California, Davis.,Section of Podiatry, Veterans Affairs Northern California Healthcare System, Sacramento
| | - R Rivkah Isseroff
- From the ∗Department of Dermatology, University of California, Davis.,Section of Dermatology
| | - Apra Sood
- From the ∗Department of Dermatology, University of California, Davis.,Section of Dermatology
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Müller CSL, Burgard B, Zimmerman M, Vogt T, Pföhler C. On the significance of negative-pressure wound therapy with instillation in dermatology. J Dtsch Dermatol Ges 2018; 14:786-95. [PMID: 27509412 DOI: 10.1111/ddg.13038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Methods used in the treatment of acute and chronic wounds undergo constant evolution, reevaluation, and innovation. While negative-pressure wound therapy (NPWT) is an established treatment modality, the combination of NPWT and instillation of normal saline as well as solutions with active antiseptic components for topical treatment of the wound bed represents a novel approach. The well-known effects of NPWT may thus be combined with those of local antisepsis. They include a decrease in wound area, induction of granulation tissue, and reduction in bacterial colonization. To date, studies have focused on NPWT with instillation for orthopedic/surgical indications, whereas clinical data in dermatosurgery is limited to case reports or small case series. There are as yet no randomized prospective studies investigating NPWT with instillation in the treatment of skin disorders. The goal of this review is to present the method of NPWT with instillation, to highlight its mode of action as well as possible complications and contraindications, and to review the recent literature. In summary, there is increasing evidence that both simple and complicated wounds may be effectively treated with NPWT with instillation, resulting in markedly accelerated tissue granulation and thus earlier defect closure.
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Affiliation(s)
| | - Barbara Burgard
- Department of Dermatology, Allergology, and Venereology, University Hospital of Saarland, Homburg/Saar, Germany
| | - Monika Zimmerman
- Department of Dermatology, Allergology, and Venereology, University Hospital of Saarland, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Allergology, and Venereology, University Hospital of Saarland, Homburg/Saar, Germany
| | - Claudia Pföhler
- Department of Dermatology, Allergology, and Venereology, University Hospital of Saarland, Homburg/Saar, Germany
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Abstract
ZusammenfassungIn der Therapie der chronisch venösen Insuffizienz oder des Lymphödems sind Kompressionsstrümpfe ein Standard der Therapie. Trotzdem ist die Akzeptanz der Patienten relativ gering. Ein Grund dafür sind unter anderem auch Symptome wie Juckreiz, Brennen oder Rötung, die vom Patienten, aber auch häufig vom behandelnden Arzt als Allergie auf die Kompressionsstrümpfe gewertet werden. Die Übersichtsarbeit geht auf die Grundlagen der Kontaktallergien ein, zeigt wie häufig Allergien auf Kompressionsstrümpfe auftreten, welche Auslöser dafür in Frage kommen und beschreibt kurz die häufigen Differenzialdiagnosen, ihre Auslöser und Prävention.
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Müller CSL, Hubner W, Thieme-Ruffing S, Pföhler C, Vogt T, Volk T, Gärtner BC, Bialas P. Pre- and perioperative aspects of dermatosurgery. J Dtsch Dermatol Ges 2017; 15:117-146. [PMID: 28214316 DOI: 10.1111/ddg.13181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 12/13/2016] [Indexed: 12/12/2022]
Abstract
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert. Said requirements include hygienic aspects, knowledge concerning pre- and intraoperative patient monitoring, managing surgical site infections, adequate postsurgical pain management, as well as detailed pharmacological knowledge with respect to common local anesthetics and the toxic and allergic reactions associated therewith. Not only does this require interdisciplinary collaboration and shared responsibility for the patient. It also necessitates the development and implementation of quality-oriented and evidence-based guidelines that, in the dermatosurgical setting, usually extend far beyond the scope of the specialty per se. The objective of the present CME article is the condensed presentation of interdisciplinary aspects relating to the most important perioperative issues.
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Affiliation(s)
- Cornelia S L Müller
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Wakiko Hubner
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sigrid Thieme-Ruffing
- Institute for Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg/Saar, Germany
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Volk
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg/Saar, Germany
| | - Barbara C Gärtner
- Institute for Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg/Saar, Germany
| | - Patric Bialas
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg/Saar, Germany
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Müller CSL, Hubner W, Thieme-Ruffing S, Pföhler C, Vogt T, Volk T, Gärtner BC, Bialas P. Prä- und perioperative Aspekte der Versorgung dermatochirurgischer Patienten. J Dtsch Dermatol Ges 2017; 15:117-148. [PMID: 28214321 DOI: 10.1111/ddg.13181_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 12/13/2016] [Indexed: 12/12/2022]
Abstract
Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf wenige Ausnahmen fast alle Eingriffe traditionell in Lokal- bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri- und postoperative Überwachung obliegt dabei dem dermatochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern. Hierzu gehören neben Hygieneaspekten, Kenntnissen in der Überwachung der Patienten sowie dem Aspekt der surgical site infections auch Fragen zur postoperativen Schmerztherapie sowie detailliertes pharmakologisches Wissen über die zur Anwendung kommenden Lokalanästhetika und das Handling der damit assoziierten toxischen und allergischen Reaktionen. Eine interdisziplinäre Zusammenarbeit und Verantwortung für den Patienten ist notwendig und erfordert die Erarbeitung und Umsetzung qualitätsorientierter und evidenzbasierter Handlungsanweisungen, die im dermatochirurgischen OP-Setting meist weit über das eigentliche Fach hinausgehen. Ziel dieses Weiterbildungsartikels soll die komprimierte Darstellung der genannten fachübergreifenden Standpunkte bezüglich der wichtigsten perioperativen Aspekte sein.
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Affiliation(s)
- Cornelia S L Müller
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Wakiko Hubner
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Sigrid Thieme-Ruffing
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Claudia Pföhler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Thomas Vogt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Thomas Volk
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Barbara C Gärtner
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Patric Bialas
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Homburg/Saar
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Erfurt-Berge C, Geier J, Mahler V. The current spectrum of contact sensitization in patients with chronic leg ulcers or stasis dermatitis - new data from the Information Network of Departments of Dermatology (IVDK). Contact Dermatitis 2017; 77:151-158. [PMID: 28194803 DOI: 10.1111/cod.12763] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with lower leg dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization. OBJECTIVES To identify the current spectrum of contact allergens in these patients. PATIENTS AND METHODS Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). RESULTS Allergic contact dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and contact sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%). CONCLUSIONS Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing.
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Affiliation(s)
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), University Medical Centre Göttingen, 37075, Göttingen, Germany
| | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen, 91054, Erlangen, Germany
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D'Erme AM, Iannone M, Dini V, Romanelli M. Contact dermatitis in patients with chronic leg ulcers: a common and neglected problem: a review 2000–2015. J Wound Care 2016; 25 Suppl 9:S23-9. [DOI: 10.12968/jowc.2016.25.sup9.s23] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - M. Iannone
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - V. Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - M. Romanelli
- Department of Dermatology, University of Pisa, Pisa, Italy
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Müller CSL, Burgard B, Zimmerman M, Vogt T, Pföhler C. Zum Stellenwert der Unterdruck-Instillationstherapie in der Dermatologie. J Dtsch Dermatol Ges 2016; 14:786-96. [PMID: 27509413 DOI: 10.1111/ddg.13038_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Die Methoden zur Behandlung akuter und chronischer Wunden unterliegen einer steten Weiterentwicklung, Reevaluierung und Anwendung innovativer Therapieformen. Die Vakuumtherapie zur Wundbehandlung gehört zu den etablierten Behandlungsmodalitäten. Ein innovatives Verfahren kombiniert die Vakuumtherapie mit der automatisierten, kontrollierten Zufuhr und Drainage wirkstoffhaltiger Lösungen zur topischen Wundbehandlung im Wundbett und auch wirkstofffrei durch Instillation physiologischer Kochsalzlösung (Unterdruck-Instillationstherapie). Hierdurch können die Effekte der konventionellen Vakuumtherapie mit denen der lokalen Antisepsis kombiniert werden. Hierdurch kommt es zu einer Reduktion der Wundfläche, einer Induktion von Granulationsgewebe sowie einer Reduktion der Keimbesiedelung der Wunden. Bisher publizierte Studien konzentrieren sich auf die Anwendung dieses Therapieverfahrens zur Behandlung orthopädisch-chirurgischer Krankheiten. Die Datenlage bezüglich der Vakuum-Instillationstherapie in der Dermatochirurgie beschränkt sich derzeit auf Fallberichte und Einzelfallerfahrungen. Randomisierte, prospektive Studien zum Vergleich der Vakuum-Instillationstherapie zur Behandlung dermatologischer Krankheitsbilder existieren bislang nicht. Ziele des vorliegenden Artikels sind die Vorstellung der Vakuumtherapie mit Instillation einschließlich ihres Wirkprinzips, deren mögliche Komplikationen, die Diskussion erdenklicher Kontraindikationen sowie eine Übersicht über die aktuell verfügbare Datenlage. Zusammenfassend scheint sich die Evidenz zu verdichten, dass mittels Unterdruck-Instillationstherapie sowohl einfache als auch komplizierte Wunden effizient behandelt werden können, was sich in einer deutlichen Beschleunigung der Wundgranulation mit konsekutiv früher möglichem Defektverschluss äußert.
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Affiliation(s)
| | - Barbara Burgard
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Monika Zimmerman
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Thomas Vogt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Claudia Pföhler
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
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9
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[Differential diagnosis of skin changes on the lower extremities in chronic venous insufficiency]. Wien Med Wochenschr 2016; 166:270-4. [PMID: 27379851 DOI: 10.1007/s10354-016-0478-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
Abstract
Varicous veins and postthrombotic syndrome can make typical reversible or irreversible skin changes on the lower extremities if no treatment is initiated. The typical clinical signs should be recognised in an early stage and possible differential diagnoses have to be excluded.
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11
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Abstract
ZusammenfassungEinleitung: Die nicht heilende Wunde stellt einen zunehmenden Kostenfaktor im Gesundheitssystem dar. Ziel der fachgerechten Wundtherapie ist es, die gestörte Wundhei-lung zu durchbrechen, um das Durchlaufen der physiologischen Abheilung zu ermögli-chen.Methoden: Es erfolgte eine selektive Literaturrecherche in den Datenbanken AWMF, PubMed und Cochrane Library mit den Schlüsselwörtern „chronic wound” oder „ulcer” in Kombination mit den Begriffen alginates, hydrofibre, hydrogel, collagen, foam.Ergebnisse: Die heute verfügbaren Wundtherapeutika erlauben es nicht, bei chronischen Wunden anstelle einer narbigen Reparatur eine physiologische Regeneration der Haut zu erreichen. Vor jeder Wundtherapie müssen mögliche Ursachen für die gestörte Wundhei-lung identifiziert werden und sofern möglich kausal therapiert werden. Zur topischen Therapie chronischer Wunden steht eine große Auswahl verschiedener Wundauflagen zur Verfügung. Die dezidierte Kenntnis dieser Wundtherapeutika ermöglicht deren differenzierten Einsatz, und ist damit die Voraussetzung für eine heilungsphasenadaptierte Anwendung.Schlussfolgerung: Die derzeitige Studienlage erlaubt kaum Rückschlüsse auf die Überlegenheit einzelner Wundauflagen bezüglich des Endpunktes Wundverschluss. Obwohl die mangelhafte Evidenz die Entscheidung bei den Behandelnden für oder gegen die einzelnen Produkte erschwert, zeigt es auch, dass teure Wundauflagen preiswerteren Alternativen nicht eindeutig überlegen sind.
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Stücker M, Altmeyer P, Reich-Schupke S. [Therapy of venous leg ulcers. New and established approaches]. Hautarzt 2012; 62:504-8. [PMID: 21523520 DOI: 10.1007/s00105-010-2114-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Venous leg ulcers are the most severe complication of chronic venous insufficiency. Based on the pathogenesis and the clinical evidence, the first step in treating a venous leg ulcer should be the treatment of the venous insufficiency. According to the guidelines of the German Society of Phlebology, several methods are available: the surgical or interventional therapy of varicosities, the stenting of stenotic pelvic veins in a post-thrombotic syndrome, direct surgical intervention at the ulcer as excision, debridement or fasciotomy. In the case of an arthrogenic venous stasis syndrome, physical therapy can be helpful. Additionally wound dressings, medicinal therapy and reduction of pain are relevant.There is a good level of evidence only for sufficient compression therapy and elimination of varicosities by surgery or sclerotherapy.
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Affiliation(s)
- M Stücker
- Klinik für Dermatologie der Ruhr-Universität Bochum, Venenzentrum der dermatologischen und gefäßchirurgischen Kliniken, Ruhr-Universität Bochum im Maria-Hilf-Krankenhaus, Hiltroper Landwehr 11-13, 44805, Bochum, Deutschland.
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Huptas L, Rompoti N, Herbig S, Körber A, Klode J, Schadendorf D, Dissemond J. Schmerzreduktion bei Patienten mit chronischem Ulcus cruris durch ein neu entwickeltes Morphingel. Hautarzt 2011; 62:280-6. [DOI: 10.1007/s00105-011-2141-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Heinlin J, Schreml S, Babilas P, Landthaler M, Karrer S. [Cutaneous wound healing. Therapeutic interventions]. Hautarzt 2010; 61:611-26; quiz 627. [PMID: 20556349 DOI: 10.1007/s00105-010-1978-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In modern medicine chronic wounds are an interdisciplinary major therapeutic and financial issue. Essential for therapy is both the causal treatment of the underlying disease and the symptomatic treatment depending on the phase of wound healing. The physiological process of cutaneous wound healing is divided into three overlapping phases: inflammation, proliferation and tissue remodelling. The choice of a suitable therapy depends on the extent of the wound, the localization, exudation and bacterial infestation. In recent years a number of novel findings were made about this complex biological process and the insights gained have resulted in new therapeutic concepts. In the following article we give an overview about possible therapeutic options and present the various modern wound dressings.
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Affiliation(s)
- J Heinlin
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
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15
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Reich-Schupke S, Kurscheidt J, Appelhans C, Kreuter A, Altmeyer P, Stücker M. Epikutantestung bei Patienten mit Ulcus cruris unter besonderer Berücksichtigung moderner Wundprodukte. Hautarzt 2010; 61:593-7. [DOI: 10.1007/s00105-010-1972-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Calow T, Oberle K, Bruckner-Tuderman L, Jakob T, Schumann H. Contact dermatitis due to use of Octenisept in wound care. J Dtsch Dermatol Ges 2009; 7:759-65. [PMID: 19228295 DOI: 10.1111/j.1610-0387.2009.07035.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Octenisept, containing 0.1 % octenidine/2 % phenoxyethanol, is a widely used antiseptic in modern wound management. It is considered to have a very low allergenic potential. Thus far, neither allergic nor irritant contact dermatitis to the product has been described. PATIENTS AND METHODS Chronic wounds in 251 patients were treated with Octenisept; 11 developed signs of contact dermatitis. The symptoms improved after discontinuation of the antiseptic. Eight of these patients were patch tested to the antiseptic and its components. RESULTS The eight patients all showed a positive reaction to the product. In at least three cases a reaction to the components cocamidopropyl betaine and phenoxyethanol was found, but not to octenidine dihydrochloride. CONCLUSIONS In this cohort, more than three percent of the treated patients developed a contact dermatitis to the antiseptic. However, the differentiation between allergic and irritant contact dermatitis towards the ingredients of the antiseptic remains problematic.
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Affiliation(s)
- Trevis Calow
- Department of Dermatology, University Medical Center Freiburg, Germany
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Abstract
Although the positive effects of negative pressure-therapy in wound-healing has been well known for several decades, the first paper on the now widely used vacuum systems was published ten years ago. Since then vacuum-therapy has been widely used in patients with"hard-to-heal" wounds, including dermatologic patients. Although there is still a lack of relevant comparative prospective controlled clinical trials, vacuum-therapy seems to accelerate the healing process in chronic wounds in both the granulation and epithelialization phases. Therefore, following debridement, vacuum-therapy can be considered as the therapy of choice for many patients with chronic wounds.
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18
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Freise J, Kohaus S, Korber A, Hillen U, Kroger K, Grabbe S, Dissemond J. Contact sensitization in patients with chronic wounds: Results of a prospective investigation. J Eur Acad Dermatol Venereol 2008; 22:1203-7. [DOI: 10.1111/j.1468-3083.2008.02775.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Körber A, Weindorf M, Dissemond J. Exsudatmanagementkapazität moderner Wundauflagen für die Therapie des Ulcus cruris venosum unter Kompressionstherapie. Hautarzt 2008; 59:904-11. [DOI: 10.1007/s00105-008-1636-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jankićević J, Vesić S, Vukićević J, Gajić M, Adamič M, Pavlović MD. Contact sensitivity in patients with venous leg ulcers in Serbia: comparison with contact dermatitis patients and relationship to ulcer duration. Contact Dermatitis 2007; 58:32-6. [DOI: 10.1111/j.1600-0536.2007.01253.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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