Tubular Compression in the Treatment of Venous Ulcers of the Leg: A New Graduated Tubular Device

2000 ◽  
Vol 15 (3-4) ◽  
pp. 169-174 ◽  
Author(s):  
C. Gardon-Mollard
Keyword(s):  
Clinical Trials ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Nursing Time ◽  
Venous Ulceration ◽  
Anatomical Model ◽  
Elastic Compression ◽  
Venous Ulcers ◽  
Elastic Stockings ◽  
Compression Treatment

Background: Compression treatment remains an effective method of healing of venous ulceration. Traditional bandaging techniques require considerable nursing time to apply. Elastic stockings are comfortable but patients find these difficult to put on over dressings. Aim: To develop a tubular compression bandage system that can be easily applied to patients with venous leg ulceration. Methods: A tubular bandage has been designed (Tubulcus) which applies 30-40 mmHg compression at the ankle with graduated compression above this. An applicator system has been designed (Tricolore) which allows the compression bandage to be applied over ulcer dressings. The device has been evaluated on a cylindrical former and an anatomical model of a leg, in order to assess its suitability for clinical trials. It has been compared with three types of compression bandage. Results: The tubular bandaging system provides sustained compression to be applied to leg ulcers whilst facilitating dressing changes. The graduated compression profile achieved with this system is more easily obtained than when using any of the three types of bandage. Conclusion: A system of application of elastic compression has been designed specifically for use in patients with venous ulceration. Clinical trials are now required to demonstrate the efficacy of this system.

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.

Oxpentifylline for venous leg ulcers

1991 ◽  
Vol 29 (15) ◽  
pp. 59-60
Keyword(s):  
Health Service ◽  
Venous Drainage ◽  
Prolonged Treatment ◽  
Leg Ulcers ◽  
Recent Trial ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Compression Bandages ◽  
Skin Circulation ◽  
Elastic Stockings

Venous ulcers are common, unsightly, difficult to heal, painful and persistent. They occur when the skin circulation is impaired secondary to poor venous drainage of the legs. Elevation of the legs, exercise, compression bandaging and, later, elastic stockings are the mainstays of treatment.1 Despite these measures, many venous ulcers fail to heal and require prolonged treatment in hospital or at home. The annual cost to the Health Service of dressings and compression bandages has been estimated at £1200 for each unhealed ulcer.2 A recent trial suggests that oxpentifylline (Trental – Hoechst) can enhance healing.3 Does this offer a much needed advance?

Compression Treatment of Chronic Venous Ulceration: A Review

2000 ◽  
Vol 15 (3-4) ◽  
pp. 162-168 ◽  
Author(s):  
G. L. Moneta ◽  
A. D. Nicoloff ◽  
J. M. Porter
Keyword(s):  
Medical Literature ◽  
Compression Therapy ◽  
Clinical Situation ◽  
Ulcer Recurrence ◽  
Compression Stockings ◽  
Venous Ulceration ◽  
Elastic Compression ◽  
Future Goals ◽  
Venous Ulcers ◽  
The Individual

Objective: To review the recent medical literature with regard to the use of compressive therapy in healing and preventing the recurrence of venous ulceration. Methods: Searches of Medline and Embase medical literature databases. Appropriate non-indexed journals and textbooks were also reviewed. Synthesis: Elastic compression therapy is regarded as the ‘gold standard’ treatment for venous ulceration. The benefits of elastic compression therapy in the treatment of venous ulceration may be mediated through favourable alterations in venous haemodynamics, micro-circulatory haemodynamics and/or improvement in subcutaneous Starling forces. Available data indicate compressive therapy is highly effective in healing of the large majority of venous ulcers. Elastic compression stockings, Unna boots, as well as multi-layer elastic wraps, have all been noted to achieve excellent healing rates for venous ulcers. In compliant patients it appears that approximately 75% of venous ulcers can be healed by 6 months, and up to 90% by 1 year. Non-healing of venous ulcers is associated with lack of patient compliance with treatment, large and long-standing venous ulceration and the coexistence of arterial insufficiency. Recurrence of venous ulceration is, however, a significant problem after healing with compressive therapy, even in compliant patients; approximately 20-30% of venous ulcers will recur by 2 years. Conclusions: Compressive therapy is capable of achieving high rates of healing of venous ulceration in compliant patients. Various forms of compression, including elastic, rigid and multi-layer dressings, are available depending on physician preference, the clinical situation and the needs of the individual patient. Compressive therapy, while effective, remains far from ideal. The future goals are to achieve faster healing of venous ulceration, less painful healing and freedom from ulcer recurrence.

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.

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.

Updated leg ulcer pathway: improving healing times and reducing costs

2019 ◽  
Vol 28 (20) ◽  
pp. S21-S26
Author(s):  
Leanne Atkin ◽  
Alison Schofield ◽  
Anita Kilroy-Findley
Keyword(s):  
Quality Of Life ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Nursing Time ◽  
Venous Leg Ulcers ◽  
Reduced Costs ◽  
Reducing Costs

Regardless of the amount of literature and evidence on leg ulcer management, there are still significant variations in treatment. Implementing a standardised leg ulcer pathway to ensure patients are appropriately and timely assessed could help reduce nursing time and overall costs, while improving healing outcomes and patients' quality of life. Such a pathway was introduced in Lincolnshire and Leicestershire, UK, to treat venous leg ulcers (VLUs). The results showed improved healing times, reduced costs and fewer nurse visits, among other findings.

Open-Label Study to Evaluate the Healing Rate and Safety of the Profore™ Extra Four-Layer Bandage System in Patients with Venous Leg Ulceration

2000 ◽  
Vol 4 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Aditya K. Gupta ◽  
Joel De Koven ◽  
Robert Lester ◽  
Neil H. Shear ◽  
Daniel N. Sauder
Keyword(s):  
Healing Rate ◽  
The Elderly ◽  
Leg Ulcers ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Venous Leg Ulcers ◽  
Initial Event ◽  
Venous Ulcers ◽  
High Compression

Background: Venous ulcers are increasing in prevalence, especially since these are observed more frequently in the elderly, and the number of individuals in this age group is becoming a larger portion of the population. Objective: To determine the healing rate and safety of the Profore™ Extra Four-Layer Bandage System in the management of venous leg ulcers. Methods: In an open-label study, patients aged 18 years or older with venous leg ulcers were treated with a high compression four-layer bandage system in which a hydrocellular dressing was placed in contact with the wound. The combination is designated the “Profore Extra Four-Layer Bandage System.” Follow-up visits took place weekly unless there was heavy exudation from the ulcer or if there was marked edema of the leg at the start of the study requiring reapplication of the bandage system. Results: Fifteen patients were entered into the study (men 8, women 7, mean age 66 years, mean duration of ulcers 1.3 years). Thirteen of the 15 patients completed the study, with two withdrawals. In one patient who withdrew, the ulcer became infected and required treatment with antibiotics. The other termination from the study occurred for reasons unrelated to treatment. The ulcer in this patient healed in 7 weeks. Ten of the 13 patients (77%) who completed the study, and 10 (67%) of 15, who had enrolled experienced complete (100%) healing. Healing of > 80% of the ulcers occurred in 11 of 13 patients (85%) who completed the study and in 12 (80%) of 15 enrolled patients. No patient experienced a study-related adverse event. One patient developed contact dermatitis and was later found to have stasis dermatitis. It is unclear whether the initial event was contact or stasis dermatitis. Conclusion: In this open-label study, a high compression system, using the Profore Extra Four-Layer Bandage with a hydrocellular dressing in contact with the wound, was found to be effective and safe for the treatment of venous leg ulcers.

scholarly journals Treatment of venous leg ulcers with an ointment containing yarrow (Achillea millefolium) extract / Primena preparata sa ekstraktom hajdučke trave (Achillea millefolium) u lečenju venskih ulkusa potkolenice

2009 ◽  
Vol 1 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Milan Matić ◽  
Verica Đuran ◽  
Marina Jovanović ◽  
Zorica Gajinov ◽  
Aleksandra Matić ◽  
...  
Keyword(s):  
Wound Healing ◽  
Saline Solution ◽  
Achillea Millefolium ◽  
Control Group ◽  
Leg Ulcers ◽  
Herbal Preparations ◽  
Venous Leg Ulcers ◽  
Accelerate Wound Healing ◽  
Venous Ulcers ◽  
Experimental Group

Abstract Traditional medicine credits yarrow (Achillea millefolium) with the ability to accelerate wound healing. The purpose of this research was to determine the effects of yarrow on the epithelization of the lower leg venous ulcers. The study included 39 patients with venous leg ulcers. They were divided into two groups: the first (experimental) group of patients were treated with an ointment containing 7.5% of yarrow extract. In the second (control) group, saline solution dressings were applied to ulcers, within the period of three weeks. In the experimental group, at the beginning of the therapy, the total surface of all the ulcers was 44736 mm2. After three weeks, the total surface of all the ulcers was 27000 mm2 (a decrease of 39.64%). In the control group, at the beginning of the therapy, the total surface of all the ulcers was 46116 mm2. At the end of the study (21 days) the total surface of all the ulcers was 39153 mm2 (a decrease of 15.1%). Herbal preparations are suitable for application in the therapy of venous ulcers, but their efficiency in wound healing is still to be investigated.

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