Ankle Motility is a Risk Factor for Healing of Chronic Venous Leg Ulcers

Objective: To investigate the effect of ankle motility on chronic venous leg ulcer healing, and to relate this to calf pump function and muscle bulk. Methods: This was a prospective cohort study undertaken in a leg ulcer clinic. Ankle motility, calf-ankle circumference ratio and calf pump power (derived from digital photoplethysmography) were assessed as to their effect on ulcer healing rate. Thirty consecutive patients undergoing multi-layer compression bandaging for open chronic venous ulcers were included. Results: Ankle motility was an independent risk factor for ulcer healing ( p = 0.001, hazard ratio 1.08, 95% CI 1.03–1.13). Ankle motility correlated with calf-ankle circumference ratio ( r = 0.48, p<0.01). No relationship was found between photoplethysmography-derived calf pump power, ankle motility or ulcer healing rate. Conclusions Ulcers in legs with poor ankle motility are slower to heal and this may be related to reduced calf muscle bulk. Ankle exercises or physiotherapy could be considered in such patients.

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Controlling compression bandaging pressure in leg ulcer research trials: A summary of the literature

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519825590 ◽

2019 ◽

Vol 34 (8) ◽

pp. 501-514 ◽

Cited By ~ 2

Author(s):

Sharon L Boxall ◽

Keryln Carville ◽

Gavin D Leslie ◽

Shirley J Jansen

Keyword(s):

Ulcer Healing ◽

Gold Standard ◽

Reliability And Validity ◽

Leg Ulcer ◽

Evidence Based ◽

Leg Ulcers ◽

Venous Leg Ulcer ◽

Practice Recommendations ◽

Compression Bandaging ◽

Literature Searches

Compression bandaging remains the ‘gold standard’ intervention for the treatment of venous leg ulcers. Numerous studies have investigated the effect of a large variety of compression bandaging techniques and materials on venous leg ulcer healing. However, the majority of these studies failed to monitor both actual bandage application pressures and the bandaging competency of participating clinicians. A series of literature searches to explore the methods, practices, recommendations and results of monitoring compression bandaging pressures in leg ulcer research trials were undertaken. This included investigating the reliability and validity of sub-bandage pressure monitors and the degree to which compression bandaging achieves the recommended sub-bandage pressure. The literature revealed inconsistencies regarding the monitoring of sub-bandage pressure and in sub-bandage pressures produced by clinicians. This creates difficulties when comparing study outcomes and attempting to develop evidence-based practice recommendations.

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Antibiotic concentration in the exudate of venous ulcers: The prediction of ulcer healing rate

British Journal of Surgery ◽

10.1002/bjs.1800700909 ◽

1983 ◽

Vol 70 (9) ◽

pp. 532-534 ◽

Cited By ~ 21

Author(s):

N. F. Gowland Hopkins ◽

C. W. Jamieson

Keyword(s):

Ulcer Healing ◽

Healing Rate ◽

Antibiotic Concentration ◽

Venous Ulcers ◽

Ulcer Healing Rate

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A Meta-analysis to Compare Four-layer to Short-stretch Compression Bandaging for Venous Leg Ulcer Healing

Wound Management & Prevention ◽

10.25270/owm.2018.5.3038 ◽

2018 ◽

Vol 64 (5) ◽

pp. 30-38 ◽

Cited By ~ 5

Author(s):

Magali Rezende De Carvalho ◽

Bruno Utzeri Peixoto ◽

Isabelle Andrade Silveira ◽

Beatriz Baptista de Oliveria

Keyword(s):

Ulcer Healing ◽

Meta Analysis ◽

Leg Ulcer ◽

Venous Leg Ulcer ◽

Compression Bandaging

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Lothian and Forth Valley Leg Ulcer Healing Trial, Part 1: Elastic versus Non-Elastic Bandaging in the Treatment of Chronic Leg Ulceration

Phlebology The Journal of Venous Disease ◽

10.1177/026835559200700402 ◽

1992 ◽

Vol 7 (4) ◽

pp. 136-141 ◽

Cited By ~ 59

Author(s):

M. J. Callam ◽

D. R. Harper ◽

J. J. Dale ◽

D. Brown ◽

B. Gibson ◽

...

Keyword(s):

Ulcer Healing ◽

Interaction Analysis ◽

Leg Ulcer ◽

Chronic Venous Disease ◽

Venous Disease ◽

Duration Of Treatment ◽

Venous Leg Ulcer ◽

Venous Ulcers ◽

Independent Evaluation ◽

Application Techniques

Objective: To determine whether elastic or non-elastic bandaging is more effective in healing chronic venous ulcers. Design: Randomized trial with factorial design and interaction analysis, enabling independent evaluation of both bandaging and dressings within the single-trial format. The duration of treatment was 12 weeks or until ulcer-healing, whichever occurred sooner. Setting: The Leg Ulcer Clinics of Edinburgh and Falkirk and District Royal Infirmaries, Scotland. Patients: 132 patients with chronic leg ulcers and clinical evidence of chronic venous disease, and excluding those with Doppler ultrasound ankle/brachial pressure indices of less than 0.8, diabetes or rheumatoid disease. There were 28 withdrawals who were classified for analysis as treatment failures. Interventions: Elastic or non-elastic multilayer bandage systems were applied using similar application techniques by a team of trained nurse specialists. All other treatments were standardized, including the randomization of dressings to either a knitted viscose or a hydrocellular polyurethane dressing. Main outcome measure: Complete ulcer healing. Results: In the elastic group 35 out of 65 ulcers (54%) healed within 12 weeks compared with 19 out of 67 (28%) in the non-elastic group (95% confidence limits for percentage healed, 9% to 42%). Ulcer pain was also reported significantly less often in the elastic group (48% of visits versus 29%; p=0.03). Conclusion: When applied by similar multilayer bandaging techniques, elastic bandaging was significantly better than non-elastic bandaging in the treatment of chronic venous leg ulcer.

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