Treatment of venous leg ulcers with sulodexide

Phlebologie ◽  
2003 ◽  
Vol 32 (05) ◽  
pp. 115-120 ◽  
Author(s):  
A. Franek ◽  
H. Koziolek ◽  
M. Kucharzewski
Keyword(s):  
Pharmacological Treatment ◽  
Healing Process ◽  
Leg Ulcers ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Group I ◽  
Group Ii

SummaryAim: The study of the influence of sulodexide in the treatment of venous leg ulcers. Patients and method: 44 patients with chronic venous ulceration were randomly divided into two groups. Group I: 21 patients (ulceration area: 12.7-18.9 cm2), Group II: 23 patients (ulceration size: 12.1-20.3 cm2). Both groups were treated by using Unna’s boot. This dressing was changed every seven days until the ulcer had healed. Additionally, the patients in group II received the systemic pharmacological treatment with sulodexide. Results: After 7 weeks of treatment ulcers of seven patients (35%) from group I had healed, and 3 weeks later the ulceration of two more patients had healed completely. After further 7 weeks the ulcers of 12 patients had healed completely. Whereas in group II after 7 weeks of treatment ulceration of 16 (70%, p <0.05) patient had healed completely and after further 3 weeks the ulcers of the remaining 7 patients had healed, too. Conclusion: The use of sulodexide in patients with chronic venous leg ulcers accelerates the healing process.

scholarly journals Cost-Effective Management of Venous Ulcer

1970 ◽  
Vol 2 (2) ◽  
pp. 136-141
Author(s):  
SAN Alam ◽  
AHM Bashar ◽  
KM Alam ◽  
MN Sabah ◽  
GMM Hossain ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ulcer Healing ◽  
Great Saphenous Vein ◽  
Cost Effective ◽  
Venous Ulcer ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Group I ◽  
Venous Surgery ◽  
Group Ii

Background: Venous disorders are very common. About 20% of the population suffer from varicose veins, 2% have skin changes which may precede venous ulceration. Venous ulcers represent a common and debilitating condition associated with significant financial loss for the patients as well as the society. Treatment options for these patients are costly and time consuming. In this study we tried to find out cost-effective measures for treating this group of patients.Method: To evaluate the effectiveness and safety of superficial and perforating leg venous surgery along with pharmacotherapy 66 patients with chronic venous leg ulcers are prospectively studied. After proper history taking and clinical examination all patients underwent venous duplex ultrasonography. Patients were divided into two groups. Group I (n=30) includes patients undergoing saphenofemoral ligation and stripping of the great saphenous vein (GSV). In group II (n=36) patients underwent saphenofemoral and incompetent leg perforator ligation along with stripping of the GSV. Conservative measures, local ulcer care and pharmacotherapy were common in both groups.Result: Postoperative complications, total hospital stay and ulcer healing were studied. Ulcer healing was earlier in group II. Remarkable complications were similar in both the groups.Conclusion: For effective and economic care of venous leg ulcers, combination of standard surgical procedures including incompetent perforator and saphenofemoral ligation with great saphenous vein stripping and standard physio-pharmacotherapeutic care is essential. This combined modality of treatment is highly effective in early and complete ulcer healing in patients suffering from venous ulcers.Keywords: Venous ulcer: Saphenofemoral ligation: Perforator ligation.  DOI: 10.3329/cardio.v2i2.6629Cardiovasc. j. 2010; 2(2) : 136-141

Frequency of Isolated Superficial Venous Incompetence in Patients with Venous Ulcers as Measured by Ambulatory Strain-Gauge Plethysmography

1995 ◽  
Vol 10 (2) ◽  
pp. 65-68 ◽  
Author(s):  
C. Hansson ◽  
J. Holm
Keyword(s):  
Strain Gauge ◽  
Screening Method ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Pressure Measurements ◽  
Venous Leg Ulcer ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Strain Gauge Plethysmography ◽  
Venous Ulcers

Objective: Identification of isolated superficial venous incompetence (SVI) in patients with clinically diagnosed venous leg ulcers using a computerized strain-gauge plethysmograph. Design: Ambulatory leg ulcer patients were assessed as to the clinical diagnosis. Diagnoses other than venous ulceration were excluded. Setting: Department of Dermatology, Sahlgrenska Hospital, Göteborg, Sweden. Patients: One hundred and fourteen patients (133 legs) with venous leg ulcers were investigated. Main outcome measures: All patients were also investigated by measuring systolic ankle and arm pressure measurements. The ankle/arm (AI) was below 0.9 in 22 of the 133 ulcerated legs. Results: Of the 111 ulcerated legs with an AI>0.9, 10% had an isolated SVI. Conclusions: Isolated SVI is an important cause of venous leg ulcer development. Strain-gauge plethysmography is an inexpensive screening method, and is easy to use. Further examination with the more exact, but also more expensive and time-consuming, colour duplex should be performed in selected cases.

Effect of foam sclerotherapy on healing and long-term recurrence in chronic venous leg ulcers

2013 ◽  
Vol 28 (3) ◽  
pp. 140-146 ◽  
Author(s):  
S R Kulkarni ◽  
F J A Slim ◽  
L G Emerson ◽  
C Davies ◽  
R A Bulbulia ◽  
...  
Keyword(s):  
Ulcer Healing ◽  
Healing Rate ◽  
Leg Ulcers ◽  
Venous Reflux ◽  
Foam Sclerotherapy ◽  
Recurrence Rates ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Venous Surgery

Introduction The ESCHAR trial showed that superficial venous surgery and compression in chronic venous ulceration achieved a 24-week healing rate of 65% and 12-month recurrence rate of 12%. Foam sclerotherapy treatment is an alternative to surgery. The aim of this study is to assess the effect of foam sclerotherapy on ulcer healing and recurrence in chronic venous leg ulcers. Methods Chronic venous leg ulcers (CEAP [clinical, aetiological, anatomical and pathological elements] 5 and CEAP 6) with superficial venous reflux were treated between March 2006 and June 2011 with ultrasound-guided foam sclerotherapy and compression. Venous duplex was performed on all legs before and after treatment. Twenty-four-week ulcer healing and one- and four-year ulcer recurrence rates were calculated using Kaplan–Meier survival analysis. Results Two hundred legs (186 patients) with chronic venous ulcers (CEAP 5: n = 163 and CEAP 6: n = 37) were treated with foam sclerotherapy. Complete occlusion was achieved in 185/200 (92.5%) limbs, short segment occlusion in 14/200 (7%) limbs and one leg segment failed to occlude. One patient suffered an asymptomatic non-occlusive deep vein thrombosis (DVT) diagnosed on duplex scan at one week and one presented with an occlusive DVT three weeks following a normal scan at one week. One patient developed an asymptomatic occlusive DVT at two weeks following a non-occlusive DVT diagnosed on initial one-week scan. Eighteen patients were lost to follow-up (3 moved away and 15 died of unrelated causes). The 24-week healing rate was 71.1% and one- and four-year recurrence rates were 4.7% and 28.1%, respectively. Conclusion Foam sclerotherapy is effective in abolition of superficial venous reflux and may contribute to similar ulcer healing and long-term recurrence rates to superficial venous surgery. Foam sclerotherapy is an attractive alternative to surgery in this group of patients.

scholarly journals Peculiarities of treatment and healing of trophic ulcers of the lower extremities of the mixed genesis

2019 ◽  
Vol 86 (7) ◽  
pp. 36-41
Author(s):  
V. I. Liakhovskyi ◽  
O. M. Bezkorovaynyy ◽  
A. V. Sydorenko
Keyword(s):  
Blood Supply ◽  
Comparison Group ◽  
Healing Process ◽  
Local Treatment ◽  
Lower Extremities ◽  
Main Group ◽  
Local Temperature ◽  
Group I ◽  
Group Ii ◽  
The Impact

Objective. To study the impact of sulodexide on the healing process of trophic ulcers of the mixed genesis in the lower extremities. Materials and methods. Analysis of the medical cards data was done for 105 patients, who in 2015 - 2019 yrs have had treated the trophic ulcers of the mixed genesis of the ankles in Department of Vascular Surgery of the Poltava Regional Clinical Hospital. The causes of development of trophic ulcers were confirmed by data of ultrasonographic color angioscanning of the lower extremities and pelvis with measurement of the ankle-brachial pressure index and arteriography. All the patients did not accepted the proposal for performing of correcting and restoration surgical treatment on the lower extremities vessels. Depending on the treatment prescribed the patients were divided into two groups. Into the Group I (comparative) 53 (50.5%) patients were included, who obtained a casual conservative treatment, directed to improvement of the lower extremities blood supply, as well as the blood rheological properties, which included venotonic, analgesic, antibacterial preparations and local treatment, depending on the wound process stage. Into the Group II (the main) 52 (49.5%) patients were included, who on the background of typical treatment have obtained sulodexide in a dose 600 LU (lipoproteidlipase units) on 200 ml of physiological solution of sodium chloride up to 15 days long with subsequent therapy in the dose of 1 capsule twice a day (500 LU) during up to 60 days. In the Group I there were 32 (60.4%) men and 21 (39.6%) women, and in the Group II – 30 (57.7%) men and 22 (42.3%) women. Average age of patients in the Group I have constituted (65.8 ± 4.38), and in the Group II – (66.2 ± 5.04) yrs old. The pain intensity in accordance to the ten-point numerical rating scale was checked before the treatment beginning, in 7 and 14 - 15 days, the trophic ulcers square was measured, local temperature of the patient’s body, pН-metry and cytological investigations of the wounds exudate were done in all the patients before the treatment. Besides this, 38 (71.7%) patients of the comparison group and 40 (76.9%) patients of the main group were followed during 90 - 120 days after leaving a stationary. Results. In the patients, who have obtained sulodexide additionally, reparative processes in the trophic ulcers regions of the lower extremities have become accelerated, the pain syndrome have been lowered rapidly, the water index normalized, the blood supply improved, the ankle-brachial index enhanced, a local temperature raised, cytological picture of the wound exudate improved, what promoted more rapid healing of ulcers and reduction of the stationary stay duration. During the planned visits of the patients in 90 - 120 days a complete healing of trophic ulcers of the lower extremities in 31 (77.5%) patients of the main group and in 24 (63.2%) patients of the comparison group was proved. Conclusion. Application of sulodexide in the treatment dosage is expedient to include into complex of treatment for trophic ulcers of the mixed origin in the lower extremities.

Acupuncture for Chronic Venous Ulceration

2003 ◽  
Vol 21 (4) ◽  
pp. 150-152 ◽  
Author(s):  
Tim Mears
Keyword(s):  
Rheumatoid Arthritis ◽  
Recent Literature ◽  
Additional Treatment ◽  
Dramatic Improvement ◽  
Leg Ulcers ◽  
Ankle Pain ◽  
Venous Ulceration ◽  
Venous Leg Ulcers

Acupuncture was used to treat a 69-year-old man for bilateral ankle pain related to his rheumatoid arthritis. This led to a dramatic improvement in one of his chronic venous leg ulcers. There is very little recent literature on such cases, where acupuncture may be a useful additional treatment.

scholarly journals Effect of topical Insulin administration on bone defect healing in diabetic rats

2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Hany Mahmoud Mahmoud ◽  
Hanyabd-elhamed Sheriff ◽  
Abd-elnasserabd-Elmoala Ismael ◽  
Alaaabd-alla Zaki
Keyword(s):  
Bone Formation ◽  
Bone Defect ◽  
Healing Process ◽  
Bone Defects ◽  
Diabetic Control ◽  
Diabetic Rats ◽  
Control Group ◽  
Group I ◽  
Group Ii ◽  
Experimental Group

Objective: insulin has been reported to possess anabolic effect on bone. Topical application of insulin in bone defects in diabetic rats has not been investigated. The objective of this study was to evaluate histologically the effect of topical administration of insulin for the restoration of tibial bone defects in diabetic rats. Materials and Methods: Sixteen adult male albino diabetic rats were grouped into two equal groups, group I (diabetic control) which had not received any graft, group II (experimental) which was diabetic and had received topical insulin loaded on PVP (Polyvinylpyrrolidone). Specimens were harvested on days seven and twenty eight days after surgical procedures, prepared and examined histologically by H&E (haematoxylin and eosin) stain, there were wide histological differences between the groups of this study along the different intervals of the study.Results:The histological results demonstrated that there was obvious retardation in resolving the inflammatory phase, organization of the blood clot and bone formation in the diabetic control group I than the experimental group II along the different intervals of this study. Moreover, there was great acceleration in granulation tissue formation, organization and bone formation in experimental group II which received the insulin PVP. Discussion: The enhancement in bone healing process was due to the effect of insulin which accelerates the bone regeneration by means of inflammation resolve, angiogenesis, proliferation and successive differentiation of mesenchymal cells. Conclusion: Topical applications of insulin in bone defects enhance new bone formation in diabetic rats.KEYWORDSInsulin; Bone defect; Tibia; Diabetes; Rats.

Venous Leg Ulcers: Is Pain a Problem?

1998 ◽  
Vol 13 (1) ◽  
pp. 14-19 ◽  
Author(s):  
L. Noonan ◽  
S. M. Burge
Keyword(s):  
Quality Of Life ◽  
Rating Scales ◽  
Rating Scale ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Leg Ulcers ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Pain Scores

Objective: To employ standardized techniques to measure and characterize the pain associated with leg ulcers of defined causes. Methods: Patients attending leg ulcer clinics were interviewed by one research nurse using a structured questionnaire. Ulcers were classified as venous, arterial or mixed depending on the clinical assessment and ankle–brachial systolic pressure index. Pain was assessed objectively using two validated instruments for scoring pain: a verbal rating scale and a pain-intensity visual analogue scale. The significance of the observations was tested using either the Mann-Whitney U-test (unpaired observations) or the Wilcoxon signed-rank test (paired observations). A profile of the quality of pain was obtained using the short-form McGill Pain Questionnaire (SF-MPQ). Quality of life was assessed using the COOP Chart System. Patients: We assessed 38 patients with venous ulcers, three patients with mixed arterial/venous ulceration and 10 patients with arterial disease. Main outcome measures: Pain scores on verbal rating scales and visual analogue scales. Results: Venous leg ulcers are painful. Although pain scores are greater in arterial ulcers, most patients with venous ulceration suffer at least moderate pain. Night pain disturbed sleep in 73% of all patients and pain affected mood in more than 50%. Dressing changes exacerbated pain. Conclusions: Pain reduces the quality of life in most patients with leg ulcers. Pain control is an essential consideration in all patients with leg ulcers.

scholarly journals INFECTIONS MANAGEMENT IN VENOUS LEG ULCERS: A SINGLE CENTER EXPERIENCE

2016 ◽  
Vol 19 (4) ◽  
pp. 232-236
Author(s):  
Cristina-Nicoleta Cozma ◽  
◽  
Laura Raducu ◽  
Andra-Elena Balcangiu-Stroescu ◽  
Daniela-Gabriela Badita ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Healing Process ◽  
Extended Period ◽  
Surgical Debridement ◽  
Favorable Outcome ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Single Center Experience ◽  
Venous Ulcers ◽  
Surgery Department

Objectives. Chronic wounds have a prolonged period of healing due to numerous factors, including infections. Venous ulcers represent almost 80% of the lower extremity ulcerations, having a great impact on the patient's quality of life. The objective of this study was to evaluate the presence of bacteria and the proper management in treating venous leg ulcers. Material and methods. The study enrolled ten patients with chronic venous leg ulcers hospitalized in the Plastic Surgery Department of the Emergency Clinical Hospital “Prof. Dr. Agrippa Ionescu”, during a period of six months. For each patient included in the study, we assessed the wounds culture and we started an antibiotic treatment, according to the antibiogram, which was completed by the surgical treatment of the wound. Outcomes. Venous leg ulcers had a favorable outcome after the administration of antibiotic therapy, surgical debridement of the wound and coverage with a skin graft. Conclusions. Venous ulcers may evolve over an extended period of time (weeks or years) and may also be associated with severe complications, such as cellulites or malignant transformation. Infections affect the healing process. Surgical debridement associated with systemic administration of antibiotics has a favorable outcome in the epithelialization of venous ulcers.

scholarly journals Comparative, prospective, and randomized study between urotherapy and the pharmacological treatment of children with urinary incontinence

2013 ◽  
Vol 11 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Renata Martins Campos ◽  
Antonio Gugliotta ◽  
Osamu Ikari ◽  
Maria Carolina Perissinoto ◽  
Adélia Correia Lúcio ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pharmacological Treatment ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Randomized Study ◽  
Muscle Training ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

OBJECTIVE: To verify and compare the results of behavioral modification plus pelvic floor muscle training and behavioral modifications plus oxybutynin chloride in children with nonmonosymptomatic enuresis. METHODS: A total of 47 children were randomized using opaque and sealed envelopes sequentially numbered. Group I was composed of 21 children who underwent antimuscarinic treatment (oxybutynin), and Group II was composed of 26 patients who underwent pelvic floor muscle training. Both groups were instructed as to behavioral modifications. RESULTS: The voiding diary results were compared each month between Groups I and II. In the first month of treatment, children in Group I presented 12.2 dry nights, 13.4 in the second month, and 15.9 in the last month. In Group II, the results were: 14.9 dry nights in the first month, 20.8 dry nights in the second and 24.0 dry nights in the last month. There was a significant difference between the groups in second and third months. CONCLUSION: Pelvic floor exercises associated with behavioral changes were more effective than pharmacological treatment in children with urinary incontinence.

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