title: Some wounds are hard to heal:  an interesting presentation of Ehlers-Danlos syndrome.
abstract: A 17-year-old female patient was admitted for an elective mini laparotomy and cystectomy of the right ovary for the treatment of chronic supra-pubic abdominal pain. The procedure went without complication and she was discharged the next day. She was re-admitted a month later as an acute case with wound dehiscence. HIV serology, thyroid function, immunoglobulin, protein electrophoresis and electrolyte levels were all normal. There were no obvious signs of infection and the bacterial swabs failed to culture an organism. Despite conservative measures with regular dressing, oral antibiotics and input from the tissue viability team the wound failed to epithelialise. The wound was debrided and re-sutured a total of three times and the patient received 24 days of intravenous antibiotics. After input from various teams a diagnosis of Ehlers-Danlos syndrome was made, allowing for appropriate management and wound healing.
authors.affiliation: Department of Obstetrics and Gynaecology, Luton and Dunstable Foundation Trust, UK. neilryan@nhs.net
authors.forename: N
authors.initials: N
authors.lastname: Ryan
authors.forename: G
authors.initials: G
authors.lastname: Walkden
authors.forename: S
authors.initials: S
authors.lastname: Akbar
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D010048:Ovarian Cysts / Q000453:epidemiology / Q000601:surgery; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000628:therapy*; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents