Venous ulcer formation and healing at cellular levels

2017 ◽  
pp. 73-89
Author(s):  
Joseph D. Raffetto
Keyword(s):  
Venous Ulcer ◽  
Ulcer Formation

scholarly journals Lipodermatosclerosis is Characterized by Elevated Expression and Activation of Matrix Metalloproteinases: Implications for Venous Ulcer Formation

1998 ◽  
Vol 111 (5) ◽  
pp. 822-827 ◽  
Author(s):  
Yared Herouy ◽  
Gudula Pornschlegel ◽  
Christoph Stetter ◽  
Harald Grenz ◽  
Erwin Schöpf ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Venous Ulcer ◽  
Ulcer Formation ◽  
Elevated Expression

scholarly journals Influences of sodium and glycosaminoglycans on skin oedema and the potential for ulceration: a finite-element approach

2019 ◽  
Vol 6 (7) ◽  
pp. 182076
Author(s):  
Wu Pan ◽  
Sara Roccabianca ◽  
Marc D. Basson ◽  
Tamara Reid Bush
Keyword(s):  
Finite Element ◽  
Fluid Pressure ◽  
Venous Ulcer ◽  
Sodium Content ◽  
Ultimate Tensile Stress ◽  
Internal Stresses ◽  
Ulcer Formation ◽  
Skin Ulceration ◽  
Calf Muscle Pump ◽  
Venous Ulcers

Venous ulcers are chronic transcutaneous wounds common in the lower legs. They are resistant to healing and have a 78% chance of recurrence within 2 years. It is commonly accepted that venous ulcers are caused by the insufficiency of the calf muscle pump, leading to blood pooling in the lower legs, resulting in inflammation, skin oedema, tissue necrosis and eventually skin ulceration. However, the detailed physiological events by which inflammation contributes to wound formation are poorly understood. We therefore sought to develop a model that simulated the inflammation, using it to determine the internal stresses and pressure on the skin that contribute to venous ulcer formation. A three-layer finite-element skin model (epidermis, dermis and hypodermis) was developed to explore the roles in wound formation of two inflammation identifiers: glycosaminoglycans (GAG) and sodium. A series of parametric studies showed that increased GAG and sodium content led to oedema and increased tissue stresses of 1.5 MPa, which was within the reported range of skin tissue ultimate tensile stress (0.1–40 MPa). These results suggested that both the oedema and increased fluid pressure could reach a threshold for tissue damage and eventual ulcer formation. The models presented here provide insights to the pathological events associated with venous insufficiency, including inflammation, oedema and skin ulceration.

A Potential Tool for the Study of Venous Ulcers: Blood Flow Responses to Load

2018 ◽  
Vol 140 (3) ◽  
Author(s):  
Wu Pan ◽  
Joshua P. Drost ◽  
Sara Roccabianca ◽  
Seungik Baek ◽  
Tamara Reid Bush
Keyword(s):  
Blood Flow ◽  
Venous Ulcer ◽  
Patient Specific ◽  
Ulcer Formation ◽  
Flow Profile ◽  
Hemodynamic Parameters ◽  
Healthy Individuals ◽  
Modeling Approach ◽  
Venous Ulcers ◽  
Global And Local

Venous ulcers are deep wounds that are located predominantly on the lower leg. They are prone to infection and once healed have a high probability of recurrence. Currently, there are no effective measures to predict and prevent venous ulcers from formation. Hence, the goal of this work was to develop a Windkessel-based model that can be used to identify hemodynamic parameters that change between healthy individuals and those with wounds. Once identified, these parameters have the potential to be used as indicators of when internal conditions change, putting the patient at higher risk for wound formation. In order to achieve this goal, blood flow responses in lower legs were measured experimentally by a laser Doppler perfusion monitor (LDPM) and simulated with a modeling approach. A circuit model was developed on the basis of the Windkessel theory. The hemodynamic parameters were extracted for three groups: legs with ulcers (“wounded”), legs without ulcers but from ulcer patients (“nonwounded”), and legs without vascular disease (“healthy”). The model was executed by two independent operators, and both operators reported significant differences between wounded and healthy legs in localized vascular resistance and compliance. The model successfully replicated the experimental blood flow profile. The global and local vascular resistances and compliance parameters rendered quantifiable differences between a population with venous ulcers and healthy individuals. This work supports that the Windkessel modeling approach has the potential to determine patient specific parameters that can be used to identify when conditions change making venous ulcer formation more likely.

The Relation of Pancreatic Secretion to Peptic Ulcer Formation

1950 ◽  
Vol 16 (2) ◽  
pp. 490-494 ◽  
Author(s):  
Edgar J. Poth ◽  
Stanley M. Fromm
Keyword(s):  
Peptic Ulcer ◽  
Pancreatic Secretion ◽  
Ulcer Formation

Actual procedures of diagnostics and treatments of crural venous ulcer in specialized German praxis and clinics

Phlebologie ◽  
2009 ◽  
Vol 38 (02) ◽  
pp. 77-82 ◽  
Author(s):  
P. Altmeyer ◽  
M. Stücker ◽  
S. Reich-Schupke
Keyword(s):  
Annual Meeting ◽  
Polyurethane Foam ◽  
Surgical Therapy ◽  
Compression Therapy ◽  
German Society ◽  
Venous Ulcer ◽  
Ulcus Cruris ◽  
Wound Dressings

Summary Background: To evaluate the implementation of the guidelines of the German Society of Phlebology for venous crural ulcer a survey was conducted during the annual meeting of the German Society of Phlebology 2008 in Bochum. Methods: All 719 medical participants got an anonymized questionnaire asking for supply of crural ulcer in their institution. Results: The recurrent 66 questionnaires (9.2%) were filled by colleagues from practice or hospital, mostly surgeons, dermatologists, phlebologists and vascular surgeons. As basic diagnostics vein doppler (56.1%), duplex (75.8%) or measurement of brachial-ankleindex (83.3%) were performed. Compression therapy is used in all institutions. Mainly used wound dressings are polyurethane foam dressings, alginates, hydrocolloids and silver dressings. About 2/3 conduct surgical therapy of ulcers. Conclusion: Supply of ulcus cruris by the participants of the annual meeting of the DGP corresponds mainly, but not in all aspects to the guidelines. Further efforts for a spread of the guidelines are necessary.

Medidas para prevenção de recidivas de úlceras venosas

2020 ◽  
Vol 10 (31) ◽  
pp. 96-104
Author(s):  
Caroline Muller Almeida ◽  
Suelen Elias da Veiga Freitas ◽  
Aline Affonso Luna ◽  
Cintia Silva Fassarella ◽  
Priscilla Alfradique de Souza
Keyword(s):  
Relapse Prevention ◽  
Selection Criteria ◽  
Preventive Measures ◽  
Venous Ulcer ◽  
Limiting Factor ◽  
Venous Ulcers ◽  
Ulcer Relapse ◽  
Varicose Ulcer ◽  
Key Word ◽  
Review Study

Identificar e analisar evidências científicas adotadas na prevenção de recidivas de úlceras venosas. Trata-se de um estudo de revisão integrativa da literatura, descritivo, de abordagem qualitativa, realizado entre outubro e novembro de 2017, a partir de consulta de bases de dados nacionais e internacionais. Os descritores utilizados foram “úlcera venosa”, “úlcera varicosa”, “recidiva” associados à palavra chave “prevenção”. Recorreu análise temática de conteúdo, emergindo duas categorias. Dos 305 artigos encontrados, 10 foram selecionados atendendo aos critérios de seleção. As principais evidências observadas foram “medidas para a prevenção de recidivas de úlceras venosas” e “facilidades e dificuldades da implementação de medidas preventivas”. Evidenciou-se que as medidas são diversas para prevenir as recidivas de úlcera venosa, no entanto, a adesão ainda é fator limitador as práticas devido à complexidade que a envolve.Descritores: Úlcera Venosa, Recidiva, Prevenção. Measures to prevent recurrence of venous ulcersAbstract: To identify and analyze scientific evidences adopted in the prevention of venous ulcers recurrences. It is an integrative literature review study, descriptive, with a qualitative approach, carried out between October and November 2017, based on consultation of national and international databases. The descriptors used were "venous ulcer", "varicose ulcer", "relapse" associated with the key word "prevention". It resorted to thematic analysis of content, emerging two categories. Of the 305 articles found, 10 were selected according to the selection criteria. The main evidences observed were "measures for the prevention of relapses of venous ulcers" and "facilities and difficulties of the implementation of preventive measures". It was evidenced that the measures are diverse to prevent the recurrence of venous ulcer, however, adherence is still a limiting factor to the practices due to the complexity that involves it.Descriptors: Venous Ulcer, Relapse, Prevention. Medidas para la prevención de recidivas de úlceras venosasResumen: Identificar y analizar evidencias científicas adoptadas en la prevención de recidivas de úlceras venosas. Este es un estudio integrador de revisión de literatura, descriptivo, con un enfoque cualitativo, realizado entre octubre y noviembre de 2017, basado en la consulta de bases de datos nacionales e internacionales. Los descriptores utilizados fueron "úlcera venosa", "úlcera varicosa", "recidiva" asociados a la palabra clave "prevención". Se recurrió análisis temático de contenido, emergiendo dos categorías. De los 305 artículos encontrados, 10 fueron seleccionados atendiendo a los criterios de selección. Las principales evidencias observadas fueron "medidas para la prevención de recidivas de úlceras venosas" y "facilidades y dificultades de la aplicación de medidas preventivas". Se evidenció que las medidas son diversas para prevenir las recidivas de úlcera venosa, sin embargo, la adherencia todavía es factor limitante en las prácticas debido a la complejidad que la envuelve.Descriptores: Úlcera Varicosa, Recurrencia, Prevención.

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