Venous Ulcers Associated with Deep Venous Insufficiency

2018 ◽  
pp. 577-587
Author(s):  
Seshadri Raju
Keyword(s):  
Venous Insufficiency ◽  
Venous Ulcers

scholarly journals Efficacy of treatment modalities for venous insufficiency patients with venous ulcers

2021 ◽  
Vol 9 (5) ◽  
pp. 1350
Author(s):  
Mehmet Senel Bademci ◽  
Cemal Kocaaslan ◽  
Fatih Avni Bayraktar ◽  
Ahmet Oztekin ◽  
Huseyin Bilal Aydin ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Treatment Modalities ◽  
Venous Ulcers ◽  
Efficacy Of Treatment

Changes in Microcirculation in Venous Ulcers with Essaven Gel

Angiology ◽  
2001 ◽  
Vol 52 (3_suppl) ◽  
pp. S23-S27 ◽  
Author(s):  
L. Incandela ◽  
G. Belcaro ◽  
M.R. Cesarone ◽  
M.T. De Sanctis ◽  
M. Griffin
Keyword(s):  
Placebo Group ◽  
Treatment Group ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Local Treatment ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Single Application ◽  
Venous Ulcers

Microcirculatory changes in chronic venous insufficiency (CVI) due to venous hypertension produce venous hypertensive microangiopathy (VHM) and lead to ulceration. VHM is charac terized by enlarged, convoluted capillaries; increase in flux, permeability, and edema; and altered microlymphatics. PO2 is decreased and CO2 increased. Capillary exchanges are altered and nutritional alterations in association with microtrauma may cause venous ulcers. The aim of this pilot, cross-over, randomized, placebo-controlled study was to evaluate the effect of local treatment with Essaven gel (EG) (single acute application) in 10 subjects with VHM and venous ulcers. The study was structured over 3 days: day 1 was used for the control evalua tion for all patients. One group was randomized for the sequence placebo (day 2) and EG the following day; the second group with the sequence EG (day 2) and placebo (day 3). Indepen dently from the sequence, measurements of flux and PO2 in standard conditions showed positive changes (significant decrease of the abnormally increased flux, PO2 increase) in the EG treatment group. Changes in the placebo group were limited and associated with skin manip ulation. In conclusion, EG acutely improves microcirculation in limbs with VHM and ulceration even with a single application.

Surgical Treatment of the Superficial and Perforating Veins

2000 ◽  
Vol 15 (3-4) ◽  
pp. 131-136 ◽  
Author(s):  
P. Gloviczki
Keyword(s):  
Surgical Treatment ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
High Ligation ◽  
Ulcer Recurrence ◽  
Perforating Veins ◽  
Post Thrombotic Syndrome ◽  
Venous Ulcers ◽  
Ulcer Surgery

Objective: To review the techniques and results of surgical treatment of the superficial and perforating veins in patients with chronic venous insufficiency. Methods: The current techniques used at the Mayo Clinic for treatment of simple varicose veins and venous ulcers are presented. Results of subfascial endoscopic perforator vein surgery (SEPS) are discussed and data from large centres are tabulated. Results are compared with those reported following non-operative management. Synthesis: High ligation and invagination stripping of the incompetent segment of the saphenous vein, with stab avulsion of branch varicosities, is the optimal surgical technique to ablate superficial venous incompetence. SEPS is safer than open perforator vein ligation and is the technique of choice to interrupt incompetent perforating veins. A review of 12 series on SEPS, that included 361 limbs, found an ulcer recurrence rate of 10% in those 211 patients who underwent ablation of superficial reflux together with SEPS. One hundred and fifty limbs had SEPS alone, without saphenous stripping: ulcer recurrence in this group at a mean of 23 months was 12%. Results in primary valvular incompetence were significantly better than in post-thrombotic syndrome. Conclusions: Ablation of superficial reflux remains the main surgical treatment of all forms of chronic venous insufficiency. SEPS is safe and effective to interrupt medial calf perforators and results in rapid ulcer healing and low recurrence in patients with primary valvular incompetence. The treatment of post-thrombotic syndrome remains a challenge. Results of the North American Venous Ulcer Surgery (NAVUS) trial, a prospective, randomised, multicentre study, will be required to provide level 1 evidence of the effectiveness of surgical treatment over medical therapy in the treatment of venous ulcers.

Persistent venous leg ulcers complicated by linear morphea: a case report

2020 ◽  
Vol 29 (Sup9) ◽  
pp. S14-S20
Author(s):  
Georgeanne Cornell ◽  
Martin Kade Hardy ◽  
Jonathon Wilson
Keyword(s):  
Venous Insufficiency ◽  
Wound Care ◽  
Venous Stasis ◽  
Term Therapy ◽  
Leg Ulcers ◽  
Common Condition ◽  
Venous Ulcers ◽  
History Of ◽  
Long Term Therapy

Soft tissue ulceration resulting from chronic venous insufficiency is a common condition that requires standardised long-term therapy, which has been thoroughly established. We report a patient with a five-year history of persistent venous stasis ulcers despite treatment consistent with traditional wound care. Resolution of the ulcers began only upon deviation from conventional therapy. This report considers non-standard treatments in patients with venous ulcers that do not progress.

Topical Treatment of Venous Microangiopathy in Patients with Venous Ulceration with Essaven Gel

Angiology ◽  
2001 ◽  
Vol 52 (3_suppl) ◽  
pp. S29-S34 ◽  
Author(s):  
M.T. De Sanctis ◽  
L. Incandela ◽  
G. Belcaro ◽  
M.R. Cesarone
Keyword(s):  
Venous Insufficiency ◽  
Local Treatment ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Control Group ◽  
Venous Ulceration ◽  
Venous Ulcers ◽  
And Control ◽  
Doppler Flux ◽  
Exchange Surface

The involvement of the microcirculation in chronic venous insufficiency (CVI), due to venous hypertension, causes venous hypertensive microangiopathy (VHM) and ulceration. VHM is char acterized by enlarged, convoluted capillaries; microvascular thrombosis; obliteration of some capillaries; increase in flux, permeability, and edema and altered microlymphatics. PO 2 is decreased and CO2 increased. Capillary exchanges are altered and nutritional alterations even tually lead to venous ulcers. Edema is associated with increased capillary pressure, reduced clearance, and increased exchange surface of capillaries, which become tortuous and glomerular-like. The aim of this randomized, placebo-controlled study was to evaluate local treatment with Essaven gel (EG) in subjects with venous microangiopathy and ulcers. Measurements of laser Doppler flux, PO2, and PCO2 in standardized conditions showed positive changes (a significant decrease of the abnormally increased flux and CO2 while PO2 increased) in the EG treatment group. Changes in the placebo and control group were more limited (changes in the placebo group were mainly associated with skin manipulation when placebo- EG was applied). In conclusion, Essaven gel, in comparison with placebo, acutely improves the microcirculation in VHM even with a single acute application.

The effect of compression ulcer stockings on the capillary filtration rate and the formation of edema

Phlebologie ◽  
2011 ◽  
Vol 40 (05) ◽  
pp. 245-250 ◽  
Author(s):  
O. Wolff ◽  
T. D. Wentel ◽  
S. W. I. Reeder ◽  
H. A. M. Neumann
Keyword(s):  
Chronic Venous Insufficiency ◽  
Healthy Subjects ◽  
Filtration Rate ◽  
Venous Insufficiency ◽  
Total Population ◽  
Venous Pressure ◽  
Capillary Leakage ◽  
Edema Formation ◽  
Capillary Filtration ◽  
Venous Ulcers

SummaryIncreased ambulatory venous pressure is the key feature of chronic venous insufficiency, and causes capillary leakage and venous edema. This capillary leakage can be measured with plethysmography and is called the capillary filtration rate (CFR).Reduction of the CFR leads to less edema formation and improves the healing of venous ulcers. Aim: To show that the use of compression ulcer stockings reduces the CFR. Methods: The capillary filtration rate of both legs of 17 patients, 6 with chronic venous insufficiency and 11 healthy subjects was measured with both (day and night) stockings, only the night stocking and without stockings. Results: The reduction of the CFR was significant (p <0.0001) for the total population in the group wearing 2 stockings versus 1 stocking (CFR=0.019 vs. 0.084 ml/100 ml/min), 1 stocking versus no stocking (CFR=0.149 vs. 0.084 ml/100 ml/min) and 2 stockings versus no stockings (CFR=0.019 vs. 0.149 ml/100 ml/ min). Conclusion: Compression ulcer stockings are highly effective in reducing CFR and thus reducing edema formation, which leads to improved healing of venous ulcers.

The Beneficial Augmentative Effect of Micronised Purified Flavonoid Fraction (MPFF) on the Healing of Leg Ulcers: An Open, Multicentre, Controlled, Randomised Study

1999 ◽  
Vol 14 (4) ◽  
pp. 151-157 ◽  
Author(s):  
W. Gliński ◽  
B. Chodynicka ◽  
J. Roszkiewicz ◽  
T. Bogdanowski ◽  
B. Lecewicz-Toruń ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Ulcer ◽  
Control Group ◽  
Cure Rate ◽  
Randomised Study ◽  
Venous Ulcers ◽  
The Mean ◽  
Flavonoid Fraction ◽  
The Cost

Objective: To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. Design: A randomised, open, controlled, multicentre study. Setting: Departments of Dermatology and University Outpatients Clinics. Patients: One hundred and forty patients with chronic venous insufficiency and venous ulcers. Intervention: Patients received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. Main outcome measure: Healing of ulcers and their reduction in size after 24 weeks of treatment. Results: The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05, OR = 2.3, 95% CI 1.1–4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients ( p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) ( p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was €1026.2 compared with €1871.8 in the control group. Conclusions: These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

Immunohistochemical Localization of Factor XIIIa in Chronic Venous Insufficiency

1994 ◽  
Vol 9 (1) ◽  
pp. 41-45 ◽  
Author(s):  
W. Vanscheidt ◽  
A. Laubert ◽  
H. Laaff ◽  
J. M. Weiss ◽  
E. Schöpf
Keyword(s):  
Wound Healing ◽  
Granulation Tissue ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Immunohistochemical Localization ◽  
Coagulation Cascade ◽  
Factor Xiiia ◽  
Impaired Wound Healing ◽  
Venous Ulcers ◽  
Plasma Activity

Objective: Factor XIIIa (FXIIIa) of the coagulation cascade (fibrin stabilizing factor) plays a crucial role in wound healing. Its plasma activity is significantly decreased in patients suffering from diseases accompanied with pathologically increased uptake of fibrin. Design: Immunohistochemical localization of FXIIIa and immunofluorescent histological labelling of fibrin in patients' biopsies and in control specimens. Procedure: Twenty-five biopsies were taken from granulation tissue of venous ulcers. Specimens of unimpaired wound healing ( n = 10) served as controls. Concentrations of FXIIIa and fibrin were estimated in all biopsies. Additionally, 10 biopsies from ulcer edges were stained with FXIIIa. Results: The fibrin uptake in ulcer tissue exceeded the amount found in control biopsies. Specimens taken from the ulcer edges contained the greatest amount of FXIIIa in both pericapillary and interstitial regions, followed by the controls. Granulation tissue taken from venous ulcers showed less FXIIIa around capillaries and in the interstitium than specimens of both other groups. Conclusion: Local FXIIIa deficiency in ulcer tissue may contribute to impaired wound healing. Sclerosis found in ulcer edges may be the morphological correlate of the high enzymatic concentrations found in specimens from this area.

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