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Treatment of the wide open wound in the Ehlers-Danlos syndrome

  • Baik, Bong Soo (Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital) ;
  • Lee, Wu Seop (Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital) ;
  • Park, Ki Sung (Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital) ;
  • Yang, Wan Suk (Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital) ;
  • Ji, So Young (Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital)
  • Received : 2018.11.12
  • Accepted : 2019.01.16
  • Published : 2019.04.20

Abstract

Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.

References

  1. Byers PH, Murray ML. Heritable collagen disorders: the paradigm of the Ehlers-Danlos syndrome. J Invest Dermatol 2012;132:E6-11. https://doi.org/10.1038/skinbio.2012.3
  2. Sharma NL, Mahajan VK, Gupta N, Ranjan N, Lath A. Ehlers-Danlos syndrome: vascular type (ecchymotic variant): cutaneous and dermatopathologic features. J Cutan Pathol 2009;36:486-92. https://doi.org/10.1111/j.1600-0560.2008.01065.x
  3. Proske S, Hartschuh W, Enk A, Hausser I. Ehlers-Danlos syndrome: 20 years experience with diagnosis and classification at the university skin clinic of Heidelber. J Dtsch Dermatol Ges 2006;4:308-18. https://doi.org/10.1111/j.1610-0387.2006.05958.x
  4. Girotto JA, Malaisrie SC, Bulkely G, Manson PN. Recurrent ventral herniation in Ehlers-Danlos syndrome. Plast Reconstr Surg 2000;106:1520-6. https://doi.org/10.1097/00006534-200012000-00012