Cosmetic, medical and surgical dermatologists all play a role in the treatment and management of wounds, according to an editorial in the October issue of Archives of Dermatology, a theme issue on wound healing.
“Medical conditions as diverse as pemphigus vulgaris, primary syphilis, lupus erythematosus and sarcoidosis all either have or can have wounds as part of their initial presentation,” writes editorialist Robert S. Kirsner, M.D., Ph.D., of the University of Miami. “Dermatologists create more wounds through surgical procedures and biopsies than any other specialty. Often, wounds are treated with surgical procedures such as debridement or grafting. Finally, with regard to cosmetic dermatology, its goals and the goals of wound healing are often the same: to fill a defect or contour, to provide dermal support and to normalize epithelialization [regrowth of tissue].”
The issue contains articles about a wide variety of wounds and aspects of their healing, including a laser system to assess wounds, aspects of leg ulcers that prevent them from healing and techniques that can make skin biopsies less prone to infection. “This issue allows the Archives to celebrate dermatology's role in advancing the science of wound care,” Dr. Kirsner writes. Because wounds are common and expensive to the American health care system, these advances will have wide benefits.
(Arch Dermatol. 2007;143(10):1318-1319.)
Patients With Leg Ulcers Have Low Levels of Exercise and Compression Therapy
Many patients with venous leg ulcers—wounds in the lower legs caused by increased blood pressure in the veins—do not exercise or use compression therapy, two vital factors that can speed healing and prevent recurrence. Maud M. Heinen, Ph.D., R.N., of Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, and colleagues interviewed 150 patients with venous leg ulcers about their exercise habits and their use of compression therapy, usually provided through elastic stockings or bandages. Participants also wore a physical activity monitor for a week before their interview. About 40 percent regularly used compression therapy. A total of 56 percent of the patients performed less than 2.5 hours of physical activity per week and 35 percent did not walk for 10 minutes at least once during the week. Also, only 35 percent performed the recommended leg exercises. “Patients should be educated and encouraged to (1) enhance physical activity through walking and leg exercises and (2) increase adherence to compression therapy,” the authors conclude.
(Arch Dermatol. 2007; 143(10):1283-1288.)