Lisa Goepel

Cost-effectiveness of treating vascular leg ulcers with UrgoStart(®) and UrgoCell(®) Contact.

Although chronic wounds have a high socio‐economic impact, data on comparative effectiveness of treatments are rare. UrgoStart® is a hydroactive dressing containing a nano‐oligosaccharide factor (NOSF). This study aimed at evaluating the cost‐effectiveness of this NOSF‐containing wound dressing in vascular leg ulcers compared with a similar neutral foam dressing (UrgoCell® Contact) without NOSF.

Wundnetze in Deutschland

ZusammenfassungHintergrundWundnetze sind strukturierte Kooperationen zwischen verschiedenen Berufsgruppen und ärztlichen Disziplinen im Bereich der Versorgung von Patienten mit chronischen Wunden. Angesichts der komplexen chronischen Verläufe dieser Patienten mit einer Vielzahl potenziell relevanter Komorbiditäten und einer Vielfalt möglicher Therapieoptionen kommt der evidenzbasierten, strukturierten Versorgung von Patienten mit chronischen Wunden eine besondere Bedeutung zu. Diese Versorgung ist jedoch sehr heterogen und vielfach unkoordiniert.ZielsetzungBestandsaufnahme der in Deutschland aktiven regionalen Wundnetze und Charakterisierung ihrer Struktur, Aktivitäten und Zielsetzungen.MethodenBundesweite Untersuchung, gerichtet an Wundexperten und Wundfachgesellschaften sowie zuvor kartierte Wundnetze. In den bereits bekannten Wundnetzen wurde eine aktualisierende Erhebung durchgeführt. Alle identifizierten Netze wurden mit einem standardisierten strukturierten Fragebogen zur Größe der Netze, zum regionalen Umfang, beteiligten ärztlichen Disziplinen und Berufsgruppen sowie deren Aktivitäten erhoben. Über die vorstrukturierten Antworten hinaus wurden Freitextangaben aufgenommen.ErgebnisseDie Anzahl der identifizierbaren Wundnetze betrug n = 35. In einem Großteil der Netze waren sowohl Ärzte und Pflegende aus Kliniken wie auch niedergelassene Ärzte und ambulante Pflegende vertreten.Die häufigsten ärztlichen Disziplinen waren Gefäßchirurgen (74 %) vor Allgemeinmedizinern (63 %), Diabetologen (60 %), Allgemeinchirurgen (60 %) und Dermatologen (57 %). Die häufigsten Aktivitäten waren informelle Zusammenkünfte zu Fortbildungen (77%), Austausch von Erfahrungen und Zweitmeinungen (je 71%) und Absprachen über Patientenversorgung (69%). Nur in wenigen Fällen wurden im Rahmen der Kooperation Selektivverträge umgesetzt.SchlussfolgerungDie in Deutschland durch Eigeninitiative von Wundexperten gegründeten Wundnetze stellen stark interdisziplinär und interprofessionell ausgerichtete Expertenplattformen mit hohem Potenzial für eine strukturierte, effiziente Versorgung dar. Wünschenswert sind Anreize zur systematischen Nutzung dieser Strukturen im Zuge einer qualitätsverbesserten und vergüteten Versorgung von Patienten mit chronischen Wunden.AbstractBackgroundWound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated.ObjectiveThis article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives.MethodsA nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged.ResultsA total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74 %), general physicians (63 %), diabetologists (60 %), general surgeons (60 %) and dermatologists (57 %). The most frequent activities were informal meetings on further education (77 %), exchange of experiences and second opinions (both 71 %) and consultation on patient treatment (69 %). Selective contracts were only implemented in very few cases.ConclusionThe wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.BACKGROUND Wound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated. OBJECTIVE This article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives. METHODS A nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged. RESULTS A total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74%), general physicians (63%), diabetologists (60%), general surgeons (60%) and dermatologists (57%). The most frequent activities were informal meetings on further education (77%), exchange of experiences and second opinions (both 71%) and consultation on patient treatment (69%). Selective contracts were only implemented in very few cases. CONCLUSION The wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.

Rapid improvement of psoriasis in a patient with lung cancer after treatment with erlotinib

We report the case of a 48-year-old woman with a rapid improvement of her psoriasis after treatment with erlotinib.A metastasised non-small cell lung cancer (NSCLC) was diagnosed and the psoriasis treatment with ustekinumab was stopped which caused a flare up of her psoriasis. This article is protected by copyright. All rights reserved.

Health-related quality of life and patient burden in patients with split-thickness skin graft donor site wounds

Split‐thickness skin grafting is a common procedure to treat different kinds of wounds. This systematic, multicentre, observational, cross‐sectional study of adult patients with split‐thickness skin graft (STSG) donor site wounds was conducted to evaluate quality of life (QoL) impairments caused by donor site wounds following split‐thickness skin grafting. Therefore, 112 patients from 12 wound centres in Germany were examined based on patient and physician questionnaires as well as a physical examination of the donor site wound. Most indications for skin grafting were postsurgical treatment (n = 51; 42.5%) and chronic wounds (n = 47; 39.2%). European QoL visual analoque scale (EQ VAS) averaged 64.7 ± 23.3, European QoL 5 dimensions (EQ‐5D) averaged 77.4 ± 30.0.

Efficacy and tolerability of liposomal polyvinylpyrrolidone-iodine hydrogel for the localized treatment of chronic infective, inflammatory, dermatoses: an uncontrolled pilot study

Infection is common in many chronic, inflammatory skin conditions but is often difficult to treat, in part due to growing bacterial resistance to antibiotics. Liposomal polyvinyl-pyrrolidone (PVP)-iodine hydrogel has a unique mode of action, combining the antiseptic and anti-inflammatory actions of PVP-iodine with the drug delivery and moisturizing properties of liposomes. We investigated the utility of liposomal PVP-iodine to treat infective dermatoses. In this prospective, single-arm (uncontrolled), open-label Phase II pilot study, patients with acne vulgaris (n=30), atopic dermatitis (n=20), impetigo contagiosa (n=10), and rosacea (n=10) received PVP-iodine (3%) hydrogel for ≤4 weeks. Global Clinical Severity score improved for all dermatoses (range: 0.5 for acne vulgaris [p<0.001] to 1.0 for impetigo contagiosa [p=0.011]). Improvements in pain, quality of life, (Freiburg Life Quality Assessment), and Eczema Area and Severity Index scores were also seen. Treatment was well tolerated; most frequent adverse events were burning (14%) or itching (9%) sensations. Thus, liposomal PVP-iodine hydrogel has potential utility as an effective treatment for inflammatory skin conditions associated with bacterial colonization.

Wundnetze in Deutschland@@@Wound networks in Germany: Struktur, Funktionen und Ziele 2014@@@Structure, functions and objectives 2014

ZusammenfassungHintergrundWundnetze sind strukturierte Kooperationen zwischen verschiedenen Berufsgruppen und ärztlichen Disziplinen im Bereich der Versorgung von Patienten mit chronischen Wunden. Angesichts der komplexen chronischen Verläufe dieser Patienten mit einer Vielzahl potenziell relevanter Komorbiditäten und einer Vielfalt möglicher Therapieoptionen kommt der evidenzbasierten, strukturierten Versorgung von Patienten mit chronischen Wunden eine besondere Bedeutung zu. Diese Versorgung ist jedoch sehr heterogen und vielfach unkoordiniert.ZielsetzungBestandsaufnahme der in Deutschland aktiven regionalen Wundnetze und Charakterisierung ihrer Struktur, Aktivitäten und Zielsetzungen.MethodenBundesweite Untersuchung, gerichtet an Wundexperten und Wundfachgesellschaften sowie zuvor kartierte Wundnetze. In den bereits bekannten Wundnetzen wurde eine aktualisierende Erhebung durchgeführt. Alle identifizierten Netze wurden mit einem standardisierten strukturierten Fragebogen zur Größe der Netze, zum regionalen Umfang, beteiligten ärztlichen Disziplinen und Berufsgruppen sowie deren Aktivitäten erhoben. Über die vorstrukturierten Antworten hinaus wurden Freitextangaben aufgenommen.ErgebnisseDie Anzahl der identifizierbaren Wundnetze betrug n = 35. In einem Großteil der Netze waren sowohl Ärzte und Pflegende aus Kliniken wie auch niedergelassene Ärzte und ambulante Pflegende vertreten.Die häufigsten ärztlichen Disziplinen waren Gefäßchirurgen (74 %) vor Allgemeinmedizinern (63 %), Diabetologen (60 %), Allgemeinchirurgen (60 %) und Dermatologen (57 %). Die häufigsten Aktivitäten waren informelle Zusammenkünfte zu Fortbildungen (77%), Austausch von Erfahrungen und Zweitmeinungen (je 71%) und Absprachen über Patientenversorgung (69%). Nur in wenigen Fällen wurden im Rahmen der Kooperation Selektivverträge umgesetzt.SchlussfolgerungDie in Deutschland durch Eigeninitiative von Wundexperten gegründeten Wundnetze stellen stark interdisziplinär und interprofessionell ausgerichtete Expertenplattformen mit hohem Potenzial für eine strukturierte, effiziente Versorgung dar. Wünschenswert sind Anreize zur systematischen Nutzung dieser Strukturen im Zuge einer qualitätsverbesserten und vergüteten Versorgung von Patienten mit chronischen Wunden.AbstractBackgroundWound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated.ObjectiveThis article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives.MethodsA nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged.ResultsA total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74 %), general physicians (63 %), diabetologists (60 %), general surgeons (60 %) and dermatologists (57 %). The most frequent activities were informal meetings on further education (77 %), exchange of experiences and second opinions (both 71 %) and consultation on patient treatment (69 %). Selective contracts were only implemented in very few cases.ConclusionThe wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.BACKGROUND Wound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated. OBJECTIVE This article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives. METHODS A nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged. RESULTS A total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74%), general physicians (63%), diabetologists (60%), general surgeons (60%) and dermatologists (57%). The most frequent activities were informal meetings on further education (77%), exchange of experiences and second opinions (both 71%) and consultation on patient treatment (69%). Selective contracts were only implemented in very few cases. CONCLUSION The wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.

[Wound networks in Germany: structure, functions and objectives 2014].

ZusammenfassungHintergrundWundnetze sind strukturierte Kooperationen zwischen verschiedenen Berufsgruppen und ärztlichen Disziplinen im Bereich der Versorgung von Patienten mit chronischen Wunden. Angesichts der komplexen chronischen Verläufe dieser Patienten mit einer Vielzahl potenziell relevanter Komorbiditäten und einer Vielfalt möglicher Therapieoptionen kommt der evidenzbasierten, strukturierten Versorgung von Patienten mit chronischen Wunden eine besondere Bedeutung zu. Diese Versorgung ist jedoch sehr heterogen und vielfach unkoordiniert.ZielsetzungBestandsaufnahme der in Deutschland aktiven regionalen Wundnetze und Charakterisierung ihrer Struktur, Aktivitäten und Zielsetzungen.MethodenBundesweite Untersuchung, gerichtet an Wundexperten und Wundfachgesellschaften sowie zuvor kartierte Wundnetze. In den bereits bekannten Wundnetzen wurde eine aktualisierende Erhebung durchgeführt. Alle identifizierten Netze wurden mit einem standardisierten strukturierten Fragebogen zur Größe der Netze, zum regionalen Umfang, beteiligten ärztlichen Disziplinen und Berufsgruppen sowie deren Aktivitäten erhoben. Über die vorstrukturierten Antworten hinaus wurden Freitextangaben aufgenommen.ErgebnisseDie Anzahl der identifizierbaren Wundnetze betrug n = 35. In einem Großteil der Netze waren sowohl Ärzte und Pflegende aus Kliniken wie auch niedergelassene Ärzte und ambulante Pflegende vertreten.Die häufigsten ärztlichen Disziplinen waren Gefäßchirurgen (74 %) vor Allgemeinmedizinern (63 %), Diabetologen (60 %), Allgemeinchirurgen (60 %) und Dermatologen (57 %). Die häufigsten Aktivitäten waren informelle Zusammenkünfte zu Fortbildungen (77%), Austausch von Erfahrungen und Zweitmeinungen (je 71%) und Absprachen über Patientenversorgung (69%). Nur in wenigen Fällen wurden im Rahmen der Kooperation Selektivverträge umgesetzt.SchlussfolgerungDie in Deutschland durch Eigeninitiative von Wundexperten gegründeten Wundnetze stellen stark interdisziplinär und interprofessionell ausgerichtete Expertenplattformen mit hohem Potenzial für eine strukturierte, effiziente Versorgung dar. Wünschenswert sind Anreize zur systematischen Nutzung dieser Strukturen im Zuge einer qualitätsverbesserten und vergüteten Versorgung von Patienten mit chronischen Wunden.AbstractBackgroundWound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated.ObjectiveThis article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives.MethodsA nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged.ResultsA total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74 %), general physicians (63 %), diabetologists (60 %), general surgeons (60 %) and dermatologists (57 %). The most frequent activities were informal meetings on further education (77 %), exchange of experiences and second opinions (both 71 %) and consultation on patient treatment (69 %). Selective contracts were only implemented in very few cases.ConclusionThe wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.BACKGROUND Wound networks are structured collaborations between various professions and medical disciplines in the field of treatment of patients with chronic wounds. In view of the complex chronic courses of such wounds with many relevant underlying diseases, comorbidities and a multitude of possible therapy options, the evidence-based structured treatment of patients with wound problems is of particular importance. However, this treatment is very heterogeneous and often uncoordinated. OBJECTIVE This article describes a stocktaking of the active regional wound networks in Germany with characterization of their structures, activities and objectives. METHODS A nationwide survey was carried out targeting wound specialists and wound societies as well as already established wound networks for which an updating was carried out. All identified networks were issued with a standardized questionnaire about the size of the network, extent of regional coverage, participating medical disciplines and professional groups and activities. In addition to the preformulated questions, free text information was also encouraged. RESULTS A total of 35 wound networks could be identified. The majority of networks consisted of representatives of hospitals as well as physicians in private practice and nursing personnel. The most frequently represented medical disciplines were vascular surgeons (74%), general physicians (63%), diabetologists (60%), general surgeons (60%) and dermatologists (57%). The most frequent activities were informal meetings on further education (77%), exchange of experiences and second opinions (both 71%) and consultation on patient treatment (69%). Selective contracts were only implemented in very few cases. CONCLUSION The wound networks established in Germany on self-initiatives represent strong interdisciplinary and interprofessional-oriented specialist platforms with a high potential for structured and efficient treatment. Incentives for systematic utilization of these structures in the course of improvements in quality and remuneration of treatment of patients with chronic wounds would be desirable.