Starace Michela, Orioni Gionathan, Alessandrini Aurora, Bruni Francesca, Baraldi Carlotta, Misciali Cosimo, Piraccini Bianca Maria
Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna.
Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Italy.
Dermatol Pract Concept. 2023 Jan 1;13(1):e2023019. doi: 10.5826/dpc.1301a19.
Digital ulcers represent a current public health issue, due to the relevant difficulties in their management and their tendency to become chronic, non-healing lesions.
Our case series represents an opportunity to discuss the main comorbidities of digital ulcers and to present an evidence-based treatment protocol that has proved highly effective in our clinical practice.
We collected the clinical data about clinical features, associated diseases and diagnostic therapeutical procedures of 28 patients with digital ulcers referred to our Wound Care Service at S. Orsola-Malpighi Hospital.
Digital ulcers were divided into 5 categories, based on the causative agent: peripheral artery disease: 5/16 females and 4/12 males, diabetes-associated wounds: 2/16 females and 1/12 males, mixed wounds: 4/12 males, pressure wounds: 3/16 females and 2/12 males, and immune-mediated diseases associated with wounds: 6/16 females and 1/12 males. Each group received specific management, based on the characteristics of the ulcer and the underlying comorbidities.
The clinical evaluation of digital wounds requires a thorough knowledge of their aetiopathogenesis. A multidisciplinary approach is necessary to achieve a precise diagnosis and correct treatment.
由于数字溃疡在管理上存在相关困难且有发展为慢性、不愈合病变的倾向,其已成为当前的一个公共卫生问题。
我们的病例系列提供了一个机会,来讨论数字溃疡的主要合并症,并提出一种在我们的临床实践中已证明非常有效的循证治疗方案。
我们收集了28例转诊至我院(圣奥索拉-马尔皮基医院)伤口护理服务中心的数字溃疡患者的临床特征、相关疾病以及诊断治疗程序等临床数据。
根据病因,数字溃疡分为5类:外周动脉疾病:女性5/16例,男性4/12例;糖尿病相关伤口:女性2/16例,男性1/12例;混合伤口:男性4/12例;压疮:女性3/16例,男性2/例;与伤口相关的免疫介导疾病:女性6/16例,男性1/12例。每组根据溃疡特征和潜在合并症接受特定管理。
数字伤口的临床评估需要全面了解其发病机制。多学科方法对于实现准确诊断和正确治疗是必要的。