title: The social and psychological impact of hard-to-heal wounds.
abstract: Hard-to-heal wounds typically present a huge challenge to the clinical team charged with their treatment. Wounds that are extremely painful and/or unsightly can have an extreme psychological impact on the patient, and this can be as crucial a consideration as the complexities involved in managing the physical healing. While resource expenditure on hard-to-heal wounds can be quantified, quality of life is less easy to evaluate, but is clearly of paramount importance to the patient. This article examines the experience of a woman treated for basal cell carcinoma of the scalp--both the immediate emotional impact of the individual stages of treatment and the wider impact on her lifestyle and her family. In addition, it considers the case from the perspective of a key member of the clinical team in order to present a rounded account of the cae study from a human perspective. The woman was finally healed using an advanced wound care product, Xelma®. The objectives of the study were to revisit a case study featured in a recent article (Bond et al, 2009) to provide an update on outcomes and to examine the case from the human perspective; to consider the impact of key clinical decisions on the patient's state of mind and emotions,and on the practicalities of everyday life; and to examine the ase from the perspective of a key clinician.
authors.affiliation: Plastic Surgery Department, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle-upon-Tyne.
authors.forename: Jane
authors.initials: J
authors.lastname: Pragnell
authors.forename: Julie
authors.initials: J
authors.lastname: Neilson
mesh_terms: D053523:Amelogenin / Q000191:economics / Q000627:therapeutic use; D001294:Attitude to Health; D002280:Basal Cell Carcinoma / Q000150:complications / Q000191:economics / Q000523:psychology* / Q000628:therapy; D017281:Cost of Illness; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D015580:Mohs Surgery; D010146:Pain / Q000209:etiology; D011788:Quality of Life / Q000523:psychology; D012535:Scalp; D017592:Skin Care / Q000379:methods / Q000451:nursing / Q000523:psychology; D012878:Skin Neoplasms / Q000150:complications / Q000191:economics / Q000523:psychology* / Q000628:therapy; D013524:Surgical Flaps; D014945:Wound Healing
chemical_list: D053523:Amelogenin