Wound management for 287 patients with chronic leg ulcers demands 12 full-time nursesLeg ulcer epidemiology and care in a well-defined population in southern Sweden

Chronic nonhealing leg ulcers are debilitating with high morbidity in a vulnerable patient population and pose a frequent clinical and socioeconomic problem. Numerous local treatment options exist, but clinical trials are rare and wound management still represents a big challenge. Recently a wound dressing based on the natural remedies Hypericum perforatum and Neem oil has been proposed for chronic wound management, but trials on nonhealing leg ulcers are missing. Uncontrolled retrospective observational case review on all patients under our supervision with chronic leg ulcers who underwent treatment with a plant-derived wound dressing based on Hypericum perforatum and Azadirachta indica (Neem) oil. It could be retrieved in a total 16 cases (11 female) with a median age of 71 years. All ulcers (7 ulcers on the leg and 9 ulcers on the feed) showed a complete healing after a median healing time of 82 days (Mean 85, range 14-180 days). No side effects occurred, medication was painless or even reduced pain. Wound dressings based on Hypericum perforatum and Neem oil are well tolerated and could be a potential additional simple treatment option in the management of non-healing leg ulcers. Prospective controlled trials are needed to confirm these observations.

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Causes and the way of treatment of patients with chronic leg ulcers

Phlebologie ◽

10.1055/s-0037-1622275 ◽

2009 ◽

Vol 38 (05) ◽

pp. 211-218 ◽

Cited By ~ 2

Author(s):

C. Wax ◽

A. Körber ◽

J. Dissemond ◽

J. Klode

Keyword(s):

Treatment Period ◽

General Practitioners ◽

Peripheral Arterial Occlusive Disease ◽

Mean Value ◽

Arterial Occlusive Disease ◽

Leg Ulcer ◽

Leg Ulcers ◽

Patient Will ◽

Peripheral Arterial ◽

Chronic Leg Ulcers

SummaryChronic leg ulcer may have various causes, which are currently not centrally recorded in Germany. It is also unclear who treats patients with chronic leg ulcers in Germany and how the basic implementation of diagnosis and treatment of these patients looks like. Patients, methods: Therefore, we started a survey of 1000 general practitioners and practising specialists in dermatology, surgery and phlebology in five different regions of Germany. We carried out the genesis of a total of 6275 patients from 62 different practising therapists, 33 specialists in dermatology, surgery or phlebology and 29 general practitioners. Results: In 66.1% of all patients we found a venous leg ulcer, in 9.1% a leg ulcer from peripheral arterial occlusive disease, and in 8.5% a mixture of both. Thus there suffered a total of 83.8% of patients on chronic venous insufficiency or peripheral arterial occlusive disease as a major factor in the genesis of the chronic leg ulcer. However, even the rarely diagnosed entities such as exogenous factors, vasculitis, pyoderma gangrenosum or infectious diseases are occur in summation in 16.2% of all patients and should therefore be known and excluded. In addition, the treatment periods and referral routes of patients with chronic leg ulcer should be identified. The analysis showed that the vast majority (86.8%) of patients with chronic ulcers who were investigated by us is treated by specialists. The treatment duration of general practitioners is 6.3 weeks (mean value) before the patient will be referred to a specialist. This treatment period is significantly shorter compared to the treatment period of the specialists, who treat their patients 14.1 weeks (mean value) before the patient will be referred to another specialist or to a clinic. Conclusion: Our results show the current aspects of aetiology and the way of treatment of patients with chronic leg ulcers in Germany.

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