S066 - WOUNDS AND ULCERS: THE GOOD, THE BAD AND THE UGLY02/19/2018, 1:00 PM ROOM 24C

ELIOT MOSTOW, MD, MPH / EMOSTOW@NEOMED.EDU

OVERVIEW / THANKS

1:00 PM

Dr. Mostow / Wound Care: A Call to action for Dermatologists to be Involved

1:20 PM

Dr. Fivenson / The A to Z of Wounds: 'WHAT'S UNDER THE ULCER?'

2:00 PM

Dr. Maderal / Connective Tissue Disease and Wounds

2:40 PM

All faculty / Getting it Right: Improving Diagnostic Accuracy In Wound Care

2:50 PM

Dr. Tang / Acute wound healing pearls

3:20 PM

Dr. Lev-Tov / Preventing Venous Leg Ulcers

A CALL TO ACTION!FOR DERMATOLOGISTS TO BE

INVOLVED IN WOUND CARE!!!!!!

COST / EPIDEMIOLOGY

• DISCLOSURE: Not comprehensive

• EPIDEMIOLOGY EASIER THAN COSTS!

• TAKE HOME MESSAGES:

• Wounds are a BIG problem!

• Often “under the radar”

• “Significant” direct and indirect costs

WHAT’S THE DIAGNOSIS?

➢Trauma

➢Infection

➢Venous insufficiency

➢Lymphedema

➢Vasculitis

➢Pyoderma gangrenosum

➢Peripheral vascular disease

➢Inflammatory bowel

disease

➢Cutaneous T-cell

lymphoma

TAKE HOME POINT

•Things are not always as they seem

•More than one diagnosis may be

relevant in etiologies of wound/problem

•Know thyself (know when to “cut bait”)

Pyoderma gangrenosum

Contact dermatitis:

Iatrogenic (neomycin)

Necrobiosis lipoidica diabeticorum & ulcers

Note measurement

reference point!

WOUND CARE: A CALL TO ACTION!

Quote

gram

.com

Amazon.com

Ccf.org

POINT ESTIMATE OF THE US WOUND BURDENBY DR. ELIOT MOSTOW, MPH AND JAN GRAUMAN, MD

“In the United States alone, chronic wounds affect 6.5 million patients.[16,17]”

“It is claimed that an excess of US$25 billion is spent annually on treatment of chronic wounds.[19]”

[16] Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med 1999; 341: 738–46. [17] Crovetti G, Martinelli G, Issi M, Barone M, Guizzardi M, Campanati B, Moroni M, Carabelli A. Platelet gel for healing cutaneous chronic wounds. Transfus Apher Sci 2004; 30: 145– 51. [19] Brem H, Stojadinovic O, Diegelmann RF, Entero H, Lee B, Pastar I, Golinko M, Rosenberg H, Tomic-Canic M. Molecular markers in patients with chronic wounds to guide surgical debridement. Mol Med 2007; 13: 30–9.

Talk over! We’ve known the answer for ~20 years

“6.5 million have chronic skin ulcers caused by pressure, venous stasis, or diabetes mellitus.” Singer AJ, Clark RA. Cutaneous wound healing. N EnglJ Med 1999; 341: 738–46.

Proprietary & unpublishedU.S. markets for wound management products. Irvine, Calif.: Medical Data International, August 1997

Original source

Not found in documentServices UDoHaH. (2004) Guidance to surveyors for long term care facilities. Guidance to Surveyors for Long Term Care Facilities on World Wide Web. URL: http://www.cms.hhs.gov/.

“Over $25 billion is spent yearly in the United States alone on treatment of chronic wounds” Brem H, et al. Molecular markers in patients with chronic wounds to guide surgical debridement. MolMed 2007; 13: 30–9

25 citations

64 citations

Sen, C., et al. (2009). Human skin wounds: A major and snowballing threat to public health and the economy. Wound Repair And Regeneration,17(6), 763-771.*

205 citations with “$25” billion

170 citations with “6.5 million”

*No other article in the literature fell within one order of magnitude in terms of forward citations for this data.

Chronic wound cost and prevalence: forward citations diagram From Google Scholar, search of full article text on Feb 22, 2016

P.D. Eastman

Passing into the realm of the unknown