Antiphospholipid antibody thrombosis. Another source of chronic wounds.
Antiphospholipid antibody thrombosis syndrome is currently not well known and probably underdiagnosed. The risk it presents for recurrent thromboembolism is both life threatening and chronic. Because patients often develop long-standing wounds, it is important for the wound care nurse to identify clients suspect for the disease. Several theories exist speculating on the mechanism of thrombosis involving antiphospholipid antibodies, and each focuses on changes at the interface between the vessel, cell wall membrane, and its interaction with circulating antibodies. As wound care nurses, we should consider antiphospholipid antibody thromboses whenever encountering a recalcitrant wound without obvious underlying cause. Thrombosis can occur anywhere, although 41% of presentations are cutaneous. Recurrent deep vein thrombosis with coexisting venous insufficiency can lead to a missed diagnosis of antiphospholipid thrombosis syndrome, despite evidence of pain and tissue necrosis that is typical of the disease. In any event, long-standing nonhealing wounds are always a signal to revise a diagnosis and seek alternative causes for failure of healing.
Robertson
Dawna L
DL
Cleveland Clinic Foundation School of Enterostomal Therapy, USA. wag-tails@cox.net
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000523:psychology / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000451:nursing* / Q000628:therapy; D013927:Thrombosis / Q000150:complications*; D014945:Wound Healing