scholarly journals Bacterial cellulose an effective material in the treatment of chronic venous ulcers of the lower limbs

2021 ◽  
Vol 32 (7) ◽  
Author(s):  
Liliada G. Silva ◽  
Amanda V. Albuquerque ◽  
Flávia C. M. Pinto ◽  
Rafaela S. Ferraz-Carvalho ◽  
José L. A. Aguiar ◽  
...  
Keyword(s):  
Bacterial Cellulose ◽  
Social Impact ◽  
Essential Fatty Acids ◽  
Clinical Intervention ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Public Health Services ◽  
Venous Ulcers ◽  
Initial Area ◽  
Absence From Work

AbstractChronic venous ulcers (CVU) of the lower limbs (LL) are common and cause psychological changes and significant social impact, as they make the patient susceptible to pain, absence from work and social bonds. Some materials are suggested as dressings for the treatment of CVU, but they are expensive and are generally not available for use in public health services. To evaluate the efficacy of the treatment for lower limbs (LL) chronic venous ulcer (CVU) using bacterial cellulose (BC), gel and multi-perforated film associated. A randomized controlled clinical-intervention study was performed among participants with LL CVU, divided into two groups: experimental (EG), treated with BC wound dressing and control (CG), treated with a cellulose acetate mesh impregnated with essential fatty acids (Rayon®). The participants were followed for 180 days, evaluated according to the MEASURE methodology. Thirty-nine patients were treated, 20 from the EG and 19 from the CG. In both groups, the wound area decreased significantly (p < 0.001), the healing rate was similar to the CG. The mean number of dressing changes in the SG was 18.33 ± 11.78, while in the CG it was 55.24 ± 25.81, p < 0.001. The healing dressing of bacterial cellulose, gel and associated film, when stimulating the epithelization of the lesions, showed a significant reduction in the initial area, with a percentage of cure similar to the Rayon® coverage. In addition to requiring less direct manipulation of ulcers.

scholarly journals Efficacy of bacterial cellulose membrane for the treatment of lower limbs chronic varicose ulcers: a randomized and controlled trial

2017 ◽  
Vol 44 (1) ◽  
pp. 72-80 ◽  
Author(s):  
LUCIANA MARINS CAVALCANTI ◽  
FLÁVIA CRISTINA MORONE PINTO ◽  
GLÍCIA MARIA DE OLIVEIRA ◽  
SALVADOR VILAR CORREIA LIMA ◽  
JOSÉ LAMARTINE DE ANDRADE AGUIAR ◽  
...  
Keyword(s):  
Bacterial Cellulose ◽  
Controlled Trial ◽  
Health Department ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Controlled Study ◽  
Control Group ◽  
Cellulose Membrane ◽  
Ulcer Disease ◽  
Venous Ulcers

ABSTRACT Objective: to evaluate the efficacy of Bacterial Cellulose (BC) membrane dressings in the treatment of lower limb venous ulcers. Methods: we carried out a prospective, randomized, controlled study of 25 patients with chronic venous ulcer disease in the lower limbs from the Angiology and Vascular Surgery Service of the Federal University of Pernambuco Hospital and from the Salgado Polyclinic of the County Health Department, Caruaru, Pernambuco. We randomly assigned patients to two groups: control group, receiving dressings with triglyceride oil (11 patients) and experimental group, treated with BC membrane (14 patients). We followed the patients for a period of 120 days. Results: There was a reduction in the wound area in both groups. There were no infections or reactions to the product in any of the groups. Patients in the BC group showed decreased pain and earlier discontinuation of analgesic use. Conclusion: BC membrane can be used as a dressing for the treatment of varicose ulcers of the lower limbs.

scholarly journals Treatment of Chronic Venous Ulcers Using New Four Layers Compressive Bandage Dressing

2015 ◽  
Vol 53 (199) ◽  
pp. 156-161 ◽  
Author(s):  
Kaushal K Tiwari ◽  
Krishna G Shrestha ◽  
Bijay Sah ◽  
D.Jaypal Reddy
Keyword(s):  
Compression Therapy ◽  
Venous Ulcer ◽  
Term Treatment ◽  
Lower Limbs ◽  
High Morbidity ◽  
Current Standard ◽  
Venous Ulcers ◽  
Long Term Treatment ◽  
Group A ◽  
Group B

Introduction: Lower-extremity ulcers represent the largest group of ulcers presenting to an outpatient department. It is a cumbersome, difficult to treat disease, which causes high morbidity and huge cost for the patient and healthcare system. Current standard treatment includes compression therapy. However, majority of patients need long term treatment with minimal efficacy. Aim of our study is to evaluate efficacy of four layers compressive bandages for the management of chronic venous ulcers. Methods: In Group A, we have prospectively included 20 patients with chronic venous ulcers on lower limbs for four layers hosiery bandage using Velfour bandage. Other 15 patients, Group B, were treated with conventional wound dressing. Velfour and crepe bandage were done once weekly for three weeks. Results: DVT was cause of chronic venous ulcer in 70% patient in group A and in 73.3% in Group B. Majority of patients were having left sided chronic venous ulcers. The mean duration of the ulcers was 15.6 vs 10.86 months (group A vs. group B). At the end of 3rd week, in 55% wounds in Group A were healed except few big and deep wounds remained. Most of these wounds also became smaller with minimal discharge. Size of wounds significantly decreased in Group A vs. Group B patients (0.7±0.81 cm vs. 1.73±0.77 cm, p<0.00031). However, cost of treatment in group A remained higher than group B. Conclusions: Our study has shown that four layer compressive bandage using Velfour is an easy, effective, and reproducible method of treatment for the chronic venous ulcer.  Keywords: compression bandage; treatment; venous ulcer.

scholarly journals ROLE OF PLATELET RICH PLASMA IN TREATMENT OF CHRONIC NON-HEALING VENOUS ULCER

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Firdaus A. Dekhaiya ◽  
Jignesh K. Joshi ◽  
Sarav Bamania
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Healing Process ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Venous Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Adhesive Proteins ◽  
Autologous Platelet

Introduction: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the lower limbs. Considering that PRP is a source of growth factors, and consequently has mitogenic, angiogenic, and chemotactic properties, it represents an adjunctive treatment for recalcitrant wounds. Moreover, PRP provides the wound with adhesive proteins, such as fibrinogen, which are important in wound healing. PRP contain more amount of platelets, cytokines and growth factors which are dispersed in a very small amount of plasma which can be prepared from a sample of centrifuged autologous blood. Application of PRP has been reported to be effective in both acute as well as chronic non healing venous ulcers. Aim and Objective: To evaluate the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Material and Method: A Prospective study conducted on 100 patients of chronic venous ulcers admitted in Sir T. Hospital Bhavnagar from June 2018 to June 2019 after fulfilled our inclusion and exclusion criteria. PRP then injected intalesionally inside and around the periphery of the wound/ulcer. This process was done once/week for 12 weeks. At every week, the area and volume of ulcer was calculated and photographs were taken. Result: All the patients showed healing of the ulcer with reduction in size of ulcer more than 90% was observed in 72 patients, followed by 80–90% reduction in wound size in 18 patients after the 12 weeks follow-up. Overall, significant reduction in size of ulcer was observed in all the treated patients. Conclusion: Autologous platelet rich plasma (PRP) as an autologous method, it is biocompatible, simple, safe, affordable and less expensive procedure in the treatment of chronic venous ulcers. PRP is found to be useful in improving and enhancing the healing process in chronic venous leg ulcers without any side effect. Keywords:  Venous ulcer, Platelet rich plasma

scholarly journals Is chronic venous ulcer curable? A sample survey of a plastic surgeon

2011 ◽  
Vol 44 (01) ◽  
pp. 104-109
Author(s):  
V. Alamelu
Keyword(s):  
Main Tool ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Sample Survey ◽  
Foot Care ◽  
Compression Stockings ◽  
Treatment And Prevention ◽  
Venous Ulcers ◽  
Choice Of Treatment ◽  
Surgical Modality

ABSTRACT Introduction: Venous ulcers of lower limbs are often chronic and non-healing, many a time neglected by patients and their treating physicians as these ulcers mostly do not lead to amputation as in gangrenous arterial ulcer and also cost much to complete the course of treatment and prevention of recurrence. Materials and Methods: One hundred and twenty two lower limb venous ulcers came up for treatment between May 2006 and April 2009. Only twenty nine cases completed the treatment. The main tool of investigation was the non invasive Duplex scan venography. Biopsy of the ulcer was done for staging the disease. Patients’ choice of treatment was always conservative and as out-patient instead of hospitalisation and surgery, which required a lot of motivation by the treating unit. Results: Out of twenty nine cases, ten cases were treated conservatively and seven (24.13%) healed well. Remaining nineteen cases were given surgical modality in which fifteen cases (51.74%) were successful. Only seven cases (24.13%) failed to heal. Compression stockings were advised to control oedema, varices and pain. Foot care, regular exercises and follow-up were stressed effectively.

scholarly journals Enzymatic activity analysis of MMP-2 and 9 collected by swab from lower limb venous ulcers

2014 ◽  
Vol 13 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Flávio Santos da Silva ◽  
Diego Neves Araujo ◽  
João Paulo Matos Santos Lima ◽  
Adriana Augusto de Rezende ◽  
Bento João da Graça Azevedo Abreu ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Minimum Degree ◽  
Great Majority ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Gelatinolytic Activity ◽  
Total Protein Content ◽  
Activation Time ◽  
Venous Ulcers ◽  
Enzymatic Activation

Metalloproteinases play a role in repair of venous ulcers of the lower limbs. The great majority of studies of metalloproteinase enzyme activity conducted to date have employed material from biopsies of ulcers. We evaluated the viability of using zymography to measure the enzyme activity of metalloproteinases 2 and 9 in samples of venous ulcer exudate collected on swabs. The method chosen for processing the samples proved viable in terms of its ability to provide adequate protein concentrations for analysis. Using zymography, we observed that the parameters that provided the best results for analysis of gelatinolytic activity were 0.125 to 0.5 μg of total protein content in the gels and enzymatic activation time of 19 hours (at 37 °C). Collection of venous ulcer fluid using swabs proved to be a simple, rapid and effective method for obtaining samples for measurement of gelatinolytic activity with a minimum degree of invasivity.

Medidas para prevenção de recidivas de úlceras venosas

2020 ◽  
Vol 10 (31) ◽  
pp. 96-104
Author(s):  
Caroline Muller Almeida ◽  
Suelen Elias da Veiga Freitas ◽  
Aline Affonso Luna ◽  
Cintia Silva Fassarella ◽  
Priscilla Alfradique de Souza
Keyword(s):  
Relapse Prevention ◽  
Selection Criteria ◽  
Preventive Measures ◽  
Venous Ulcer ◽  
Limiting Factor ◽  
Venous Ulcers ◽  
Ulcer Relapse ◽  
Varicose Ulcer ◽  
Key Word ◽  
Review Study

Identificar e analisar evidências científicas adotadas na prevenção de recidivas de úlceras venosas. Trata-se de um estudo de revisão integrativa da literatura, descritivo, de abordagem qualitativa, realizado entre outubro e novembro de 2017, a partir de consulta de bases de dados nacionais e internacionais. Os descritores utilizados foram “úlcera venosa”, “úlcera varicosa”, “recidiva” associados à palavra chave “prevenção”. Recorreu análise temática de conteúdo, emergindo duas categorias. Dos 305 artigos encontrados, 10 foram selecionados atendendo aos critérios de seleção. As principais evidências observadas foram “medidas para a prevenção de recidivas de úlceras venosas” e “facilidades e dificuldades da implementação de medidas preventivas”. Evidenciou-se que as medidas são diversas para prevenir as recidivas de úlcera venosa, no entanto, a adesão ainda é fator limitador as práticas devido à complexidade que a envolve.Descritores: Úlcera Venosa, Recidiva, Prevenção. Measures to prevent recurrence of venous ulcersAbstract: To identify and analyze scientific evidences adopted in the prevention of venous ulcers recurrences. It is an integrative literature review study, descriptive, with a qualitative approach, carried out between October and November 2017, based on consultation of national and international databases. The descriptors used were "venous ulcer", "varicose ulcer", "relapse" associated with the key word "prevention". It resorted to thematic analysis of content, emerging two categories. Of the 305 articles found, 10 were selected according to the selection criteria. The main evidences observed were "measures for the prevention of relapses of venous ulcers" and "facilities and difficulties of the implementation of preventive measures". It was evidenced that the measures are diverse to prevent the recurrence of venous ulcer, however, adherence is still a limiting factor to the practices due to the complexity that involves it.Descriptors: Venous Ulcer, Relapse, Prevention. Medidas para la prevención de recidivas de úlceras venosasResumen: Identificar y analizar evidencias científicas adoptadas en la prevención de recidivas de úlceras venosas. Este es un estudio integrador de revisión de literatura, descriptivo, con un enfoque cualitativo, realizado entre octubre y noviembre de 2017, basado en la consulta de bases de datos nacionales e internacionales. Los descriptores utilizados fueron "úlcera venosa", "úlcera varicosa", "recidiva" asociados a la palabra clave "prevención". Se recurrió análisis temático de contenido, emergiendo dos categorías. De los 305 artículos encontrados, 10 fueron seleccionados atendiendo a los criterios de selección. Las principales evidencias observadas fueron "medidas para la prevención de recidivas de úlceras venosas" y "facilidades y dificultades de la aplicación de medidas preventivas". Se evidenció que las medidas son diversas para prevenir las recidivas de úlcera venosa, sin embargo, la adherencia todavía es factor limitante en las prácticas debido a la complejidad que la envuelve.Descriptores: Úlcera Varicosa, Recurrencia, Prevención.

Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

2022 ◽  
pp. 153473462110659
Author(s):  
Michele Neves Brajão Rocha ◽  
Carol Viviana Serna Gonzalez ◽  
Eline Lima Borges ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Soraia Assad Nasbine Rabeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Onset Time ◽  
Venous Ulcer ◽  
High Recurrence Rate ◽  
Ulcer Recurrence ◽  
Clinical Approach ◽  
Historical Cohort ◽  
Venous Ulcers

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

scholarly journals Treatment of venous ulcers in drug addicts: A case report

2021 ◽  
Vol 12 (4) ◽  
pp. 439-441
Author(s):  
Mirela Vasileva ◽  
Vesna Brishkoska Boshkovski ◽  
Andrej Petrov
Keyword(s):  
Wound Healing ◽  
Case Report ◽  
Multidisciplinary Approach ◽  
Venous Ulcer ◽  
Lifestyle Changes ◽  
Drug Addicts ◽  
Wound Botulism ◽  
Venous Ulcers ◽  
Serious Infections ◽  
Cutaneous Anthrax

Venous ulcers are common in drug addicts and, although the management of these wounds is the same as in other patients, there are differences in the approach and the outcome of treatment. Those injecting drugs are at risk of serious infections, such as necrotizing fasciitis, wound botulism, and cutaneous anthrax due to the nature of the substances being injected. Herein, we present two cases of venous ulcers in drug addicts in their thirties. Both patients had been suffering from a venous ulcer for several years and the final result differed in the two patients. We concluded that it is necessary to raise awareness of the importance of treatment and lifestyle changes. The multidisciplinary approach in these patients may contribute to the improvement of wound healing.

Multizentrische randomisierte und kontrollierte Studie zum Vergleich von Four layer Bandagen und Kurzzugbinden des venösen Ulkus

VASA ◽  
2001 ◽  
Vol 30 (2) ◽  
pp. 108-113 ◽  
Author(s):  
H. Partsch ◽  
R.J. Damstra ◽  
D.J. Tazelaar ◽  
S. Schuller-Petrovic ◽  
A.J. Velders ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Local Therapy ◽  
Healing Time ◽  
Complete Healing ◽  
Venous Ulcers ◽  
Kaplan Meier ◽  
Initial Area ◽  
Dutch Study ◽  
Ulcer Healing Rate ◽  
Randomised Controlled

Background: Aim of the study was to compare the healing rates of venous ulcers obtained with four-layer bandages (4LB) versus short stretch bandages (SSB). Design: Multicentre, randomised controlled trial performed in 5 centres of the Netherlands and in 2 centres in Austria ("PADS-study" = Profore™ Austrian Dutch Study). Patients and methods: 112 patients (53 treated with 4LB and 59 treated with SSB) completed at least one post-treatment follow-up, 90 completed the study. Bandaging and ulcer assessment was performed at weekly intervals. Randomisation was carried out for each centre and was stratified according to the size (more or less than 10 cm2) of the ulcerated area. Local therapy consisted of plain absorbing, non-adherent dressings. Time to complete healing was recorded up to a maximum of 16 weeks. The two treatment-groups were comparable regarding their baseline-characteristics. Results: In total 33/53 (62%) of ulcer-patients were healed in the 4LB group, compared with 43/59 (73%) in the SSB group (difference 11%, 95% CI –28% to 7%). 77% of the ulcers with an initial area less than 5cm2 healed as compared with 33% of the larger ulcers. The different healing rates in the centres could be explained by the different sizes of the treated ulcers. Based on Kaplan-Meier estimates the median healing time was 57 days for the 4LB (95% CI 47–85 days) and 63 days for the SSB (95% CI 43–70 days). Conclusion: The ulcer healing rate and the median healing time did not differ among the two types of bandages. The main discriminant criterion for healing was the initial ulcer size. In centres who are experienced users of short-stretch bandages, no statistically significant different healing rates of venous ulcers could be found after 4LB or SSB.

Stanozolol and the Treatment of Venous Ulceration — An Interim Report

1986 ◽  
Vol 1 (3) ◽  
pp. 197-203 ◽  
Author(s):  
G. T. Layer ◽  
M. C. Stacey ◽  
K. G. Burnand
Keyword(s):  
Rank Test ◽  
Inclusion Criteria ◽  
Double Blind ◽  
Venous Ulceration ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Log Rank Test ◽  
Initial Area ◽  
Standard Regime

A report on an interim analysis of a large placebo-controlled double-blind randomized clinical trial evaluating the role of fibrinolytic enhancement in the management of venous ulceration is described. Seventy-five patients with venous ulcers have entered the trial and fulfilled the inclusion criteria. The ulcers were treated by a standard regime of compression bandaging combined with the oral administration of placebo or stanozolol (Stromba; Sterling Research Laboratories, Guildford). Treatment was continued until healing, and the healing times were compared between the two groups. Sixty-five per cent of ulcers treated with stanozolol have healed and 61.5 % on placebo. There was no overall difference in the healing times of patients treated with stanozolol or placebo. When the healing times were analysed after stratification into initial size, there was no difference between the ulcers of small (less than 2 cm2) or large (greater than 5 cm2) initial area, but for the ulcers between 2 and 5 cm2 there was a trend in favour of improved healing for those ulcers treated with stanozolol ( P = 0.13, log rank test).

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