EWMA 2013 - Ep453 - Diagnosing cancer in recurring ulcers using Telemedicine

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Telemedicine is being used at the Copenhagen Wound Healing Centre to facilitate communication between primary care nurses, general practitioners, and wound specialists regarding patients with chronic ulcers. Through this telemedicine program, nurses can send data and photos of ulcers to specialists. If the specialist determines an ulcer looks suspicious, the patient is called in for a biopsy. In 4 cases, basal-cell carcinomas or planocellular carcinomas were diagnosed in ulcers that previously appeared atypical. Telemedicine allows for faster specialist referral and diagnosis of cancers in chronic ulcers.

Health & Medicine Business

Diagnosing cancer in recurring
ulcers using Telemedicine
Introduced by:
Merete Hartun Jensen (DH,RN)
Lisbeth Vorbeck (RN)
Anne‐Mette Rølling (RN)
Copenhagen Wound Healing Centre (CWHC)
CWHC

Telemedicine is mostly used over distance,
or when there is a lack of specialists
emedicine at CWHC is used for communication between:
The patient, nurses in primary sector, GP´s and wound

e district nurses send data and pictures of their patients
chronic wounds

Wound specialists at CWHC receive data
This looks
suspicious!
Do you agree?
‐ I totally agree!
‐We must see this
patient soon and take a
biopsy.

• Clinical investigation is made
•A biopsy is taken
• A new appointment is made
to discuss test results
At CWHC

patients, referred by telemedicine, were called to
ther examination at CWHC outpatient clinic
lcers was atypically looking and a biopsies were taken
4 of these cases basal‐cell carcinomer or planocelluar
rcinoma was diagnosed
2012

alignant skin changes are common in chronic ulcers1
rly diagnose is vital in management of carcinomas,
sociated with chronic non healing ulcers2
alignancy should be considered in ulcers that are
ypical, deteriorating or not responding to conventional
erapy after a few months3
eviews and studies show:

tients are seen sooner then before by a specialist
cause of the fast referral procedure by telemedicine
an ulcer looks atypical the patient is seen in the
tpatient clinic and a biopsy is taken
lemedicine can help to diagnose chronic ulcers
ey Points

e four patients with carcinoma had seemingly
ignificant recurrent ulcers
or to telemedicine these patients would not have been
erred to a wound specialist because of the wounds size
d history
emedicine is valuable as a communication tool
s new referral procedure using telemedicine makes it
onclusion:

Copenhagen Wound Healing Centre
Thank you for your attention
Fell free to contact us if you have any questions
Wounddk.Bispebjerg@RegionH.dk

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