scholarly journals An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teresa J. Kelechi ◽  
Robin C. Muise-Helmericks ◽  
Laurie A. Theeke ◽  
Steven W. Cole ◽  
Mohan Madisetti ◽  
...  

Abstract Background Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30–50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of inflammation and immunity. Loneliness is highly prevalent in persons with CVLUs, has damaging effects on health, and contributes to the development of multiple chronic conditions, promotes aberrant inflammation, and diminishes healing. However, the confluence of loneliness, inflammation and the wound healing trajectory has not been elucidated; specifically whether loneliness substantially mediates systemic inflammation and alters healing over time. This study seeks to address whether there is a specific biomarker profile associated with loneliness, CVLUs, and wound healing that is different from non-lonely persons with CVLUs. Methods An observational prospective study will identify, characterize and explore associations among psychosocial stressors, symptoms and biomarkers between 2 CVLU groups, with loneliness+ (n = 28) and without loneliness- (n = 28) during 4 weeks of wound treatment, measured at 3 time points. We will examine psychosocial stressors and symptoms using psychometrically-sound measures include PROMIS® and other questionnaires for loneliness, social isolation, depression, anxiety, stigma, sleep, fatigue, pain, quality of life, cognition, and function. Demographics data including health history, sex, age, wound type and size, wound age, and treatment will be recorded from the electronic health record. We will characterize a biomarker panel of inflammatory genes including chemotaxic and growth factors, vascular damage, and immune regulators that express in response to loneliness to loneliness and CVLUs using well-established RNA sequence and PCR methods for whole blood samples. In an exploratory aim we will explore whether age and sex/psychological stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker profile over the study period. Discussion This study will provide insight into the influence of psychosocial stressors, symptoms, and biological mechanisms on wound healing, towards advancing a future healing prediction model and interventions to address these stressors and symptoms experienced by persons with CVLUs.

2007 ◽  
Vol 22 (2) ◽  
pp. 49-55 ◽  
Author(s):  
R Ogrin ◽  
P Darzins ◽  
Z Khalil

Objectives: Venous leg ulcers represent a major clinical problem, with poor rates of healing. Ideal treatment is compression bandaging. The effect of compression on neurovascular tissues involved in wound repair is unclear. This study aims to assess the effect of four-layer compression therapy (40 mmHg) on neurovascular function and wound healing in people with chronic venous leg ulcers – 15 people (55 years or older) with venous leg ulcers for more than six weeks. Methods: Basal microvascular perfusion measurement (MPM), oxygen tension (tc pO2) measured at sensor temperatures of 39°C and 44°C and sensory nerve function using electrical cutaneous perception thresholds (ECPT) at 5, 250 and 2000 Hz (corresponding to C, A δ and A β fibres) were assessed adjacent to the ulcer site, and at a mirror location on the non-ulcerated limb. Testing was undertaken before and after therapy for 5–12 weeks of four-layer compression bandaging. Results: There was significant improvement in tc pO2 at 44°C and ECPT at 2000 Hz ( P<0.05) compared with pre-intervention. Changes in basal MPM, tc pO2 at 39°C and ECPT at 5 and 250 Hz after compression therapy did not reach statistical significance. Conclusion: Four-layer compression bandaging in people with venous leg ulcers improved some components of neurovascularture in people with chronic venous leg ulcers. Whether this improvement has contributed to wound healing in this study requires further investigation.


2009 ◽  
Vol 1 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Milan Matić ◽  
Verica Đuran ◽  
Marina Jovanović ◽  
Zorica Gajinov ◽  
Aleksandra Matić ◽  
...  

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.


2018 ◽  
Vol 15 (3) ◽  
pp. 441-453 ◽  
Author(s):  
Daisy Smith ◽  
Rebecca Lane ◽  
Rosemary McGinnes ◽  
Jane O'Brien ◽  
Renea Johnston ◽  
...  

2005 ◽  
Vol 14 (8) ◽  
pp. 391-394 ◽  
Author(s):  
D. Kopera ◽  
R. Kokol ◽  
C. Berger ◽  
J. Haas

2005 ◽  
Vol 4 (4) ◽  
pp. 214-224 ◽  
Author(s):  
Uwe Wollina ◽  
Wolf-Dieter Schmidt ◽  
Claudia Krönert ◽  
Cornelia Nelskamp ◽  
Armin Scheibe ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Rutger C. Lalieu ◽  
Ida Akkerman ◽  
Rob A. van Hulst

Background: Venous leg ulcers (VLUs) are common and have a large impact on healthcare budgets worldwide. Hyperbaric oxygen therapy (HBOT) may improve healing of these ulcers.Methods: Retrospective, single-center cohort study between 2013 and 2019. All patients with a VLU from an outpatient clinic providing HBOT and wound care were included. The primary outcome measure was wound healing, determined at discharge from the center. Other outcome measures were improvement in patient related outcome measures (PROMs), as assessed by the EQ-5D-3L questionnaire and including quality of life (QoL) and pain score.Results: Fifty patients were included, 53% female, with a mean age of 73.4 (±12.2). Most wounds (83%) had existed longer than 3 months before starting treatment. Patients received an average of 43 (±20) sessions of HBOT. After treatment, 37 patients (63%) achieved complete or near-complete wound healing. Wound size decreased from a median of 14 cm2 [interquartile range (IQR) 32 cm2] to 0.5 cm2 (IQR 5.3 cm2), a median decrease of 7.5 (IQR 16.2 cm2) in cm2 (94%). Patients mostly reported improvement for all health aspects on the questionnaire. Pain score decreased from 5.7 (±2.5) to 2.1 (±2.2) (p &lt; 0.0001) and health score increased from 57.2 (±15.6) to 69.9 (±18.9) (p = 0.02).Conclusions: Patients with non-healing VLUs may benefit from HBOT to achieve complete or substantial wound healing. We recommend a well-designed randomized clinical trial with a number of patients allowing enough statistical power, and of a reasonable duration, to establish the potential of additional HBOT on hard-to-heal venous ulcers.


2015 ◽  
Vol 151 (3) ◽  
pp. 320 ◽  
Author(s):  
Elizabeth Yim ◽  
Robert S. Kirsner ◽  
Robert S. Gailey ◽  
David W. Mandel ◽  
Suephy C. Chen ◽  
...  

2020 ◽  
Vol 9 (9) ◽  
pp. e44996967
Author(s):  
Denise Viviane Ferreira Del Castilo ◽  
Marcello Magri Amaral ◽  
Carla Roberta Tim ◽  
Cintia Cristina Santi Martignago ◽  
Daniela Bezerra Macedo ◽  
...  

The aim of this study was to evaluate and compare the effectiveness of Unna’s boot and ozone therapy on chronic venous leg ulcers. Seven patients with chronic venous leg ulcers were taken into the study and were randomly divided into two groups: Unna’s boot treatment group (BU); Ozone treatment group (OZ). The therapies were performed weekly until wound closure. The morphological descriptive results demonstrated that during the treatments, it was possible to observe the presence of semi-planar borders, granulation tissue, reduction of edema, fibrin and exudate and absence of odor. These morphological modifications were more pronounced in the OZ when compared to the BU. Furthermore, both treatments promoted the same wound healing time, never the less the ozone therapy produced a higher percentage of weekly wound reduction compared to Unna's boot. Unna's boot and ozone therapy treatments appeared to positively impact the course of wound healing in chronic wounds, however the ozone therapy may improve the healing of chronic venous leg ulcers in a higher weekly percentage.


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