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 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 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 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 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.

The treatment of venous leg ulcers with a specifically designed compression stocking kit

Phlebologie ◽  
2008 ◽  
Vol 37 (04) ◽  
pp. 191-197 ◽  
Author(s):  
V. Mattaliano ◽  
G. Mosti ◽  
V. Gasbarro ◽  
M. Bucalossi ◽  
W. Blättler ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Compression Stocking ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
Time To Completion ◽  
Validated Questionnaire ◽  
First Choice ◽  
Ankle Movement

SummaryTraditionally, venous leg ulcers are treated with firm nonelastic bandages. Medical compression stockings are not the first choice although comparative studies found them equally effective or superior to bandages. Patients, methods: We report on a multi-center randomized trial with 60 patients treated with either short stretch multi-layer bandages or a two-stocking system (Sigvaris® Ulcer X® kit). Three patients have been excluded because their ankle movement was restricted to the extent that they could not put on the stockings and 1 patient withdrew consent. Patient characteristics and ulcer features were evenly distributed. The proportion of ulcers healed within 4 months and the time to completion of healing were recorded. Subjective appraisal was assessed with a validated questionnaire. Results: Complete wound closure was achieved in 70.0% (21 of 30) with bandages and in 96.2% (25 of 26) with the ulcer X kit (p = 0.011). Ulcers with a diameter of up to about 4cm healed twice as rapidly, the larger ones as fast with the stocking kit as with bandages. The sum of problems encountered with bandages was significantly greater than that observed with the stocking kit (p < 0.0001). Pain at night and in the morning was absent with stockings but reported by 40% and 20% in the bandage group, respectively. The cardinal features associated with delayed or absent healing were ulcer size and pain. Conclusions: Common venous ulcers can readily be treated with the ulcer X compression kit provided the ankle movement allow its painless donning. Bandages, even when applied by the most experienced staff are less effective and cause more problems.

Healing venous ulcers with different modalities of leg compression

Phlebologie ◽  
2006 ◽  
Vol 35 (05) ◽  
pp. 349-355 ◽  
Author(s):  
E. O. Brizzio ◽  
G. Rossi ◽  
A. Chirinos ◽  
I. Cantero ◽  
G. Idiazabal ◽  
...  
Keyword(s):  
Wound Care ◽  
Univariate Analysis ◽  
Compression Therapy ◽  
Healing Time ◽  
Clinical Parameters ◽  
Compression Stockings ◽  
Local Pressure ◽  
Ulcer Size ◽  
Venous Ulcers ◽  
Unexpected Findings

Summary Background: Compression therapy (CT) is the stronghold of treatment of venous leg ulcers. We evaluated 5 modalities of CT in a prospective open pilot study using a unique trial design. Patients and methods: A group of experienced phlebologists assigned 31 consecutive patients with 35 venous ulcers (present for 2 to 24 months with no prior CT) to 5 different modalities of leg compression, 7 ulcers to each group. The challenge was to match the modality of CT with the features of the ulcer in order to achieve as many healings as possible. Wound care used standard techniques and specifically tailored foam pads to increase local pressure. CT modalities were either stockings Sigvaris® 15-20, 20-30, 30-40 mmHg, multi-layer bandages, or CircAid® bandaging. Compression was maintained day and night in all groups and changed at weekly visits. Study endpoints were time to healing and the clinical parameters predicting the outcome. Results: The cumulative healing rates were 71%, 77%, and 83% after 3, 6, and 9 months, respectively. Univariate analysis of variables associated with nonhealing were: previous surgery, presence of insufficient perforating and/or deep veins, older age, recurrence, amount of oedema, time of presence of CVI and the actual ulcer, and ulcer size (p <0.05-<0.001). The initial ulcer size was the best predictor of the healing-time (Pearson r=0.55, p=0.002). The modality of CT played an important role also, as 19 of 21 ulcers (90%) healed with stockings but only 8 of 14 with bandages (57%; p=0.021). Regression analysis allowed to calculate a model to predict the healing time. It compensated for the fact that patients treated with low or moderate compression stockings were at lower risk of non-healing. and revealed that healing with stockings was about twice as rapid as healing with bandages. Conclusion: Three fourths of venous ulcers can be brought to healing within 3 to 6 months. Healing time can be predicted using easy to assess clinical parameters. Irrespective of the initial presentation ulcer healing appeared more rapid with the application of stockings than with bandaging. These unexpected findings contradict current believes and require confirmation in randomised trials.

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 Impact of Wearing Graduated Compression Stockings on Psychological and Physiological Responses during Prolonged Sitting

2018 ◽  
Vol 15 (8) ◽  
pp. 1710 ◽  
Author(s):  
Masahiro Horiuchi ◽  
Chieko Takiguchi ◽  
Yoko Kirihara ◽  
Yukari Horiuchi
Keyword(s):  
Physiological Responses ◽  
Lower Limbs ◽  
Compression Stockings ◽  
Nerve Activity ◽  
Parasympathetic Nerve ◽  
Prolonged Sitting ◽  
Saliva Cortisol ◽  
Healthy Young People ◽  
Graduated Compression Stockings ◽  
The Impact

We investigated the impact of wearing vs. not wearing graduated compression stockings on psychological and physiological responses in 18 healthy young people (12 men and six women) during 3 h prolonged sitting. Profiled of Mood States (POMS) scores did not show marked differences between with and without stockings. A 3 h sit significantly decreased saliva cortisol in both conditions; with no differences between conditions. Wearing stockings suppressed a subjective uncomfortable sensation (e.g., pain; fatigue; swelling) in the lower limbs, as assessed by visual analogue scale (VAS). Increase in heart rate at 1 h and 3 h was significantly greater without than with stockings. In addition, high-frequency oscillations (HF: 0.15–0.4 Hz), used as an indicator of parasympathetic nerve activity, showed higher values with than without stockings throughout the 3 h sitting period—significantly higher at 1 h. When data for both conditions were pooled pre-to-post changes in saliva cortisol were positively associated with higher uncomfortable sensations of VAS in the lower limbs and negatively associated with changes in the Vigor subscale of POMS. Collectively, these findings suggest that wearing graduated compression stockings may benefit from subjective comfort and increased parasympathetic nerve activity.

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