Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life

Abstract

Depression is a very common comorbidity in patients with chronic wounds. At least 30% of those patients suffer from depressive symptoms or anxiety. To measure impairment on daily life, different quality of life (QoL) questionnaires can be used as well as specialized questionnaires to evaluate different levels of depression. In this review, we present some of the current measurement tools and effects of depression on QoL. Depression is often associated with wound duration, odor of wounds, and furthermore with pain and immobility. On the other hand, depression might reduce wound healing itself via psychoimmunological effects. QoL, in general, is reduced in patients with chronic wounds, but especially in the case of pain, immobility and older age, and sometimes independent to wound status (healed or active). Treating medical and health care personnel should establish depression and QoL questionnaires in daily practice and should consider the psychological health of their patients as part of their treatment.

Microbiome‐skin‐brain axis: A novel paradigm for cutaneous wounds

“…Perhaps an analogous pathway for neural activation and potential modulation of mood and cognition in chronic wound patients may derive from the recent finding that S. aureus injection in the skin triggered pain by directly activating nociceptors . Thus, altered microbiota in a wound may contribute to altered mood by virtue of increasing pain, which is a significant risk factor for depression . Studies on “neuroinflammation” suggest that inflammatory conditions may cause dual effects on the immune and nervous systems via canonical immune receptors, such as cytokine receptors, being expressed in both .…”

“…Approximately $28‐31 billion is spent annually on chronic wound treatment . In addition to the financial cost, chronic wounds can lead to prolonged hospitalizations, work loss, disability, amputations in 25% of patients with diabetic foot ulcers, and poor quality of life . Indeed, wound patients have a wide range of comorbidities including depression and anxiety .…”

“…In addition to the financial cost, chronic wounds can lead to prolonged hospitalizations, work loss, disability, amputations in 25% of patients with diabetic foot ulcers, and poor quality of life . Indeed, wound patients have a wide range of comorbidities including depression and anxiety . However, the causative factors that may lead to depression in wound patients have not been fully determined, warranting further study of the pathophysiological mechanisms involved.…”

“…Depression, anxiety, and impaired cognition are associated with chronic wounds of multiple etiologies, including diabetic foot ulcers (DFU), venous ulcers, arterial ulcers, pressure ulcers, surgical wounds, and other traumatic wounds . A cross‐sectional large‐scale multicenter study demonstrated that the odds of depression among patients with leg ulcers were significantly higher than for patients with other skin diseases including psoriasis, atopic dermatitis, and nonmelanoma skin cancer .…”

Lumbar Sympathectomy in an Ankylosing Spondylitis Patient with Vasculitis: A Case Report

“…10, 11 Our patient was on the verge of depression which is a common tragedy in chronic leg ulcer patients as it is well reported. 12 The result in this case report showed that sympathetic block could be an option in treating patients with chronic vascular ulcer. According to the practice guidelines for chronic pain management by the American Society of Anesthesiologists, LSB are indicated for the treatment of multitude of sympathetic mediated pain disorders.…”