Journal of Clinical & Experimental Dermatology Research
Open Access
ISSN: 2155-9554
+44 1478 350008
ISSN: 2155-9554
+44 1478 350008
Marianna Sallustro
University of Naples Federico II, Italy
Scientific Tracks Abstracts: J Clin Exp Dermatol Res
Statement of the Problem: The impact of lockdown due to COVID-19 pandemic on wound care is scarcely reported in the literature. We carried out a study aimed to evaluate the impact of two lockdown periods during coronavirus disease 2019 (COVID-19) on the course and management of non-healing vascular ulcers of lower limbs. The present study is innovative in that in fact it reports on treatment of vascular leg ulcers made challenging by COVID-19 pandemic. Methodology and theoretical orientation: A total of 41 patients were included in the study. Before pandemic began they had been seen at our unit at weekly intervals. During lockdown from March 9 to May 4, 2020 subjects were not allowed to enter hospital unless they needed emergency surgery or oncological management. During the second lockdown, from October 19 to December 11, 2020 patients could be followed up at distance by direct outreach including telephoning contacts. Data obtained early after each lockdown were compared with those obtained prior to pandemic. Findings: Data for first lockdown show that there was an increase of recurrence rate of wounds as well as of their severity as compared with those of prelockdown period. Risk of lower limb amputation was also considerably greater .Data for second lockdown indicate that clinical course of skin lesions had not worsened. The management of vascular wounds was impacted by pandemic unfavorably with health care failures in the hospital as well as in the primary care settings. Conclusions & Significance: Treatment of vascular leg ulcers is challenged by COVID-19 pandemic as this spreads worldwide. This seems to be in keeping with what happens for other diseases. The data we obtained indicate that the pandemicrelated lockdown has a deleterious effect on vascular skin wounds, with an increase of severity and of mortality risk. To our knowledge in this context, training patients in self-care may improve outcome greatly even when wounds are managed at distance, by telemedicine. Triage is of great help in establishing priorities based on clinical severity and selecting those patients who require hospitalization and perhaps emergency surgery. However our study suggest that wound care service is essential for patients with vascular ulcers of lower limbs who have poor health and are at increased risk of infections due to impaired immune response and if they do not receive appropriate therapy, including wound monitoring and debridement, are at risk of losing limb or even life. Considering our experience national and local governments as well as scientific committees and health care officials should focus their attention on the impact of a biological storm, such as COVID-19 pandemic is, on vulnerable patients in order to protect them at their best.
Marianna Sallustro is a doctor in Vascular and Endovascular Surgery Unit in Department of Public Health at University of Naples Federico II, Naples, Italy.