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

1992 ◽  
Vol 7 (4) ◽  
pp. 136-141 ◽  
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.

scholarly journals Healing Rates of Venous Leg Ulcer Using Four Layer Bandage and Short Stretch Bandage- A Comparative Study in Aspect of Bangladesh

2020 ◽  
Vol 16 (2) ◽  
pp. 78-85
Author(s):  
Rakibul Hasan ◽  
Md Saif Ullah Khan ◽  
Mainul Mahmud ◽  
Samaresh Chandra Saha ◽  
Sourav Bhowmick
Keyword(s):  
Primary Outcome ◽  
Single Layer ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Secondary Outcome ◽  
P Value ◽  
Venous Disease ◽  
Venous Leg Ulcer ◽  
Time Duration

Background: Chronic venous leg ulcer is one of the common medical conditions encounter by the vascular surgeons in Bangladesh. Many of these patients develop venous leg ulcer as a sequel of the disease. In advance chronic venous disease such as development of ulcer, single or multilayer dressings are usually used. Objective: To find out a compression therapy (single layer crepe/short stretch bandage and multilayer/four layer bandage) in patients with venous leg ulcer. Materiel & Methods: This study was conducted on 200 patients with in last two years, march 2017 to february 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of vascular surgery. In which 100 patients with venous leg ulcer where treated with four layer bandage and another 100 patients with same condition were treated with single layer crepe bandage. Before application of bandage, proper history of patient was taken and duplex scan was done. The primary outcome was measured by time duration of ulcer healing. Secondary outcome included incidence and number of adverse events in every patient. Results: Healing time of venous ulcers was accessed with periodic interval. The four layer bandage was associated with significantly shorter time of healing. P value reached from unpaired t-test. Primary outcome shows 68% of patients who received four layer bandages achieved healing within one month. On the other hand, 12% of patients who received single layer/crepe bandage did so. Conclusion: Four layer bandages heals venous leg ulcer more rapidly than the single layer crape bandage. These data suggest that the benefits observed the consistent despite prognosis is different. Patients with large ulcers have poor healing prognosis regardless of its treatment modalities. University Heart Journal Vol. 16, No. 2, Jul 2020; 78-85

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

2001 ◽  
Vol 16 (1) ◽  
pp. 38-40 ◽  
Author(s):  
J. R. Barwell ◽  
M. Taylor ◽  
J. Deacon ◽  
C. Davies ◽  
M. R. Whyman ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pump Power ◽  
Ulcer Healing ◽  
Independent Risk Factor ◽  
Healing Rate ◽  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Ulcer Healing Rate

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.

scholarly journals A qualitative study on the patient's narrative in the progression of chronic venous disease into a first venous leg ulcer: a series of events

2019 ◽  
Vol 183 (2) ◽  
pp. 332-339 ◽  
Author(s):  
A.M. Meulendijks ◽  
M. Welbie ◽  
E.P.M. Tjin ◽  
L. Schoonhoven ◽  
H.A.M. Neumann
Keyword(s):  
Qualitative Study ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Leg Ulcer

A scoping review on Chronic Venous Disease and the development of a Venous Leg Ulcer: The role of obesity and mobility

2020 ◽  
Vol 29 (3) ◽  
pp. 190-196
Author(s):  
A.M. Meulendijks ◽  
W.M.A. Franssen ◽  
L. Schoonhoven ◽  
H.A.M. Neumann
Keyword(s):  
Scoping Review ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Leg Ulcer

Venous leg ulcer in the context of chronic venous disease

2013 ◽  
Vol 29 (4) ◽  
pp. 220-226 ◽  
Author(s):  
F S Lozano Sánchez ◽  
J Marinel Io Roura ◽  
E Carrasco Carrasco ◽  
J R González-Porras ◽  
J R Escudero Rodríguez ◽  
...  
Keyword(s):  
Short Form ◽  
Cross Sectional Study ◽  
Leg Ulcer ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Control Group ◽  
Venous Disease ◽  
Venous Leg Ulcer ◽  
Cross Sectional ◽  
Venous Clinical Severity Score

Objectives Chronic venous disease (CVD) is a frequent disorder with a high socioeconomic impact. Little is known about the possible differences between healed ulcer (C5 group) and active ulcer (C6 group) in terms of disease severity and quality of life (QoL). Our aim was to determine the possible differences in severity disease and QoL between the C5–C6 and C1 (control) group. Methods Data from a national, multicentre, observational and cross-sectional study ( n = 1598) were used to compare three groups of CVD: C1 ( n = 243), C5 ( n = 136) and C6 ( n = 70). CVD severity was assessed with the Venous Clinical Severity Score (VCSS) and QoL with the Short Form 12 Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Results Patients with active ulcers had a higher mean total VCSS than patients with healed ulcers ( P < 0.05). Both SF-12 and CIVIQ-20 QoL questionnaires indicated a poorer QoL in patients with ulcers than in those with C1 ( P < 0.05). Compared with the C5 group, patients with active ulcers (C6) had lower QoL scores, but the differences were not statistically significant. Conclusions Patients with venous leg ulcers (C5–C6) are associated with high severity and poor QoL. However, the healing of a leg ulcer did not contribute to improvement of QoL.

Description of venous leg ulcer healing mechanism

Leczenie Ran ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 49-58
Author(s):  
Wojciech Twardokęs ◽  
Agata Kołodziej ◽  
Andrzej Ślęzak
Keyword(s):  
Ulcer Healing ◽  
Leg Ulcer ◽  
Venous Leg Ulcer

Systematic literature review and network Meta-analysis of sulodexide and other drugs in chronic venous disease

2021 ◽  
pp. 026835552110150
Author(s):  
Giuseppe Pompilio ◽  
Andrew Nicolaides ◽  
Stavros K Kakkos ◽  
Davide Integlia
Keyword(s):  
Ulcer Healing ◽  
Observational Studies ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Lower Leg ◽  
Chronic Venous Disease ◽  
Cochrane Library ◽  
Horse Chestnut ◽  
Venous Disease ◽  
Calcium Dobesilate

Objective To assess the clinical efficacy of sulodexide, including a comparison with venoactive drugs (VAD) (micronized purified flavonoid fraction, MPFF; hydroxy-ethyl-rutosides, HR; calcium dobesilate;Ruscus extract combined with hesperidin methyl chalcone and vitamin C, Ruscus+HMC+VitC; horse chestnut seed extract, HCSE) and pentoxifylline in patients with chronic venous disease. Methods We performed a literature search in MEDLINE, Embase, and Cochrane Library for randomized controlled trials (RCTs) and observational studies. Proportion of patients with complete venous ulcer healing was the primary outcome and lower leg volume, foot volume, ankle circumference and symptoms were the secondary outcomes. Bayesian network meta-analysis (NMA) was perfomed with random effects models using only RCTs. A meta-analysis of observational studies was performed for sulodexide because no RCT could be included in NMA for symptoms or signs. Results Forty-five RCTs and eighteen observational studies were identified. Sulodexide was included only in a single NMA for the proportion of patients with complete ulcer healing and it showed to have the highest probability of being the best treatment (48%) compared with pentoxifylline (37%) and MPFF (16%). MPFF was the most effective treatment in reducing lower leg volume, CIVIQ-20 score and pain VAS scale while calcium dobesilate and Ruscus+HMC+VitC were the most effective in reducing foot volume and ankle circumference respectively. Meta-analyses of observational studies for sulodexide showed that it improves significantly the scoring of pain, feeling of swelling, heaviness and parasthesiae measured by Likert scales. Conclusions Sulodexide is at least as effective as pentoxifylline and more effective than MPFF in improving the rate of ulcer healing in patients with CVD. VADs are effective in improving venous symptoms and signs, as was also shown by sulodexide in the meta-analysis of observational studies. The relative effectiveness of sulodexide and VADs needs to be evaluated by an RCT in order to better inform clinical practice.

Linguistic validation of the 20 item-chronic venous disease quality-of-life questionnaire (CIVIQ-20)

2013 ◽  
Vol 29 (7) ◽  
pp. 484-487 ◽  
Author(s):  
R Launois ◽  
A Mansilha ◽  
F Lozano
Keyword(s):  
Quality Of Life ◽  
Mother Tongue ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Life Questionnaire ◽  
Linguistic Validation ◽  
Semantic Equivalence ◽  
Quality Of Life Questionnaire ◽  
Venous Ulcers

Our objective was to review the linguistic validation of the 20 item-ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) in the countries that have used it since its publication in 1996. Seventeen linguistic versions of CIVIQ-20 were validated using forward/backward methodology in patients presenting with chronic venous disease, stages C0s to C4 of the CEAP (clinical, aetiological, anatomical and pathological) classification (patients with venous ulcers were excluded). Most obstacles in the cross-cultural validation of CIVIQ-20 related to content and semantic equivalence. Confirmation of cultural relevance by experts with the native language as their mother tongue and the use of forward/backward translation methodology partly resolved these difficulties. CIVIQ-20 is valid for the assessment of treatment effects in multinational studies.

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