Multicomponent compression system use in patients with chronic venous insufficiency: a real-life prospective study

2021 ◽  
Vol 30 (5) ◽  
pp. 400-412
Author(s):  
Markus Stücker ◽  
Karl-Christian Münter ◽  
Cornelia Erfurt-Berge ◽  
Steffen Lützkendorf ◽  
Stephan Eder ◽  
...  
Keyword(s):  
Wound Healing ◽  
Observational Study ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Real Life ◽  
Compression Therapy ◽  
Compression System ◽  
Compression Bandages ◽  
Number Of Patients ◽  
Ankle Mobility

Objective: Compression therapy is the cornerstone of therapeutic management of patients with chronic venous insufficiency (CVI). This study aimed to evaluate the efficacy and safety of a multicomponent compression system in an unselected population of patients with CVI problems under real-life conditions. Method: A prospective, multicentre, observational study with a multicomponent two-bandage compression system (UrgoK2, Laboratoires Urgo, France) was conducted in 103 centres in Germany. Main outcomes included wound healing rate, wound healing progression, assessment of oedema and ankle mobility, local tolerability and acceptance of the compression therapy. Results: A total of 702 patients with venous leg ulcers (VLU) and/or with lower limb oedema due to CVI were treated with the evaluated system for a mean (±standard deviation) duration of 27±17 days. By the last visit, 30.9% of wounds had healed and 61.8% had improved. Limb oedema was resolved in 66.7% of patients and an improvement of ankle mobility was reported in 44.2% of patients. The skin condition under the compression therapy was also considered as improved in 73.9% of patients and a substantial reduction of pain was achieved, both in number of patients reporting pain and in pain intensity. Compression therapy with the evaluated system was ‘very well’ or ‘well’ tolerated and ‘very well’ or ‘well’ accepted by >95% of patients. These positive outcomes were in line with the general opinion of physicians on the evaluated compression bandages, which were judged ‘very useful’ or ‘useful’ for >96.6% of patients. Similar results were reported regardless of the treated condition, VLU and/or limb oedema. Conclusion: Real-life data documented in this large observational study of non-selected patients receiving compression therapy in daily practice confirm the benefits and safety profile of the evaluated compression system. This study also confirms the high-level of performance and acceptability of the system, regardless of the characteristics of the wounds or patients at initiation of the treatment. The data support the use of this multicomponent compression system as one first-line intervention in patients with symptoms caused by CVI.

The Role of Oedema Protective Drugs in the Treatment of Chronic Venous Insufficiency: A Review of Evidence Based on Placebo-Controlled Clinical Trials with Regard to Efficacy and Tolerance

1996 ◽  
Vol 11 (1) ◽  
pp. 23-29 ◽  
Author(s):  
C. Diehm
Keyword(s):  
Clinical Trials ◽  
Chronic Venous Insufficiency ◽  
Therapeutic Efficacy ◽  
Venous Insufficiency ◽  
Combined Treatment ◽  
Compression Therapy ◽  
Horse Chestnut ◽  
Protective Agents ◽  
Venous Ulcers ◽  
Number Of Patients

Objective: To review the therapeutic efficacy and tolerability of oedema protective agents such as diosmin, horse chestnut extract and O-(β-hydroxyethyl)-rutosides in the treatment of chronic venous insufficiency (CVI). Data selection: Relevant clinical studies were selected if they were performed using a double-blind, placebo-controlled design with validated instrument measurement of objective criteria and measurement of subjective criteria by standardized methods. Data synthesis: Judgement of clinical effectiveness of drug treatment with venoprotective/venotropic agents was based on the signs and symptoms of CVI. Measurements; Accepted for consideration included reduction of leg oedema, related subjective symptoms, improvement of haemodynamics and microcirculation, and improved healing of venous ulcers. Tolerability of the compounds in therapeutic use was assessed by comparing the frequency of side-effects in treatment and placebo groups. Conclusion: Oedema protective agents such as diosmin, horse chestnut extract and O-(β-hydroxyethyl)-rutosides are an appropriate option in the management of CVI. The clinical efficacy can be measured objectively and quantified by assessing oedema reduction or in the case of venous ulcers by ulcer healing rates. The extent of oedema reduction in patients with CVI is equivalent to the reduction achieved by compression therapy with elastic stockings as seen in a recent clinical study. Combined treatment of oedema protective agents and compression therapy has a better clinical benefit compared with treatment with either alone. The compounds have a favourable benefit/risk ratio. They combine proven therapeutic efficacy with excellent safety of use confirmed in a large number of patients treated in clinical trials.

scholarly journals Comparison of the Hemodynamic Performance of Two Neuromuscular Electrical Stimulation Devices Applied to the Lower Limb

2020 ◽  
Vol 10 (2) ◽  
pp. 36
Author(s):  
Sahar Avazzadeh ◽  
Andrea O’Farrell ◽  
Kate Flaherty ◽  
Sandra O’Connell ◽  
Gearóid ÓLaighin ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Neuromuscular Electrical Stimulation ◽  
Venous Stasis ◽  
Western World ◽  
Neuromuscular Stimulation ◽  
Mean Velocity ◽  
Compression Bandages

Currently, 1% of the population of the Western world suffers from venous leg ulcers as a result of chronic venous insufficiency. Current treatment involves the use of moist wound healing, compression bandages, and intermittent pneumatic compression. Neuromuscular electrical stimulation is a novel potential new therapeutic method for the promotion of increased lower limb hemodynamics. The aim of this study was to measure the hemodynamic changes in the lower limb with the use of two neuromuscular electrical stimulation devices. Twelve healthy volunteers received two neuromuscular stimulation device interventions. The GekoTM and National University of Ireland (NUI) Galway neuromuscular electrical stimulation devices were randomized between dominant and non-dominant legs. Hemodynamic measurements of peak venous velocity (cm/s), the time average mean velocity (TAMEAN) (cm/s), and ejected volume (mL) of blood were recorded. Peak venous velocity was significantly increased by the GekoTM and the NUI Galway device compared to baseline blood flow (p < 0.0001), while only the voluntary contraction produced significant increases in TAMEAN and ejected volume (both p < 0.05). Neuromuscular muscular electrical stimulation can produce adequate increases in lower limb hemodynamics sufficient to prevent venous stasis. Greater use of neuromuscular stimulation devices could be considered in the treatment of conditions related to chronic venous insufficiency but requires further research.

Adherence to and efficacy of different compression methods for treating chronic venous insufficiency in the elderly

2016 ◽  
Vol 31 (10) ◽  
pp. 723-728 ◽  
Author(s):  
Kotaro Suehiro ◽  
Noriyasu Morikage ◽  
Osamu Yamashita ◽  
Takasuke Harada ◽  
Koshiro Ueda ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Retrospective Review ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Compression Therapy ◽  
The Elderly ◽  
Compression Method

Objectives To investigate the adherence to and efficacy of different compression methods in elderly patients. Methods A retrospective review of compression therapy in 120 elderly patients (≥65 years) with chronic venous insufficiency was performed to study the initially preferred compression method, adherence to each method, and its efficacy. Results Initially, an oversize strong stocking (24%), an appropriate size moderate stocking (19%), and bandages (37%) were equally preferred. Adherence at 1 month was 69%, 96%, and 91%, respectively, and they reduced ankle circumferences in C3 patients by 1.8 ± 1.9 cm, 0.3 ± 1.7 cm, and 2.9 ± 1.7 cm, respectively. The improvement rates of C4 symptoms were 79%, 60%, and 91%, respectively. Only three patients (2%) preferred an appropriate size strong stocking. Conclusions In elderly patients, an appropriate size strong stocking was not preferred. The best adherence was achieved by using a moderate stocking, while the best efficacy was achieved by using bandages.

scholarly journals Initial experience with novel CGRP-receptor inhibitor therapy in Migraine in the United Arab Emirates: a retrospective observational study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bui Bao Khanh Dinh ◽  
Waseem Hamed Aziz ◽  
Alessandro Terruzzi ◽  
Derk Wolfgang Krieger
Keyword(s):  
Observational Study ◽  
Odds Ratio ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Real Life ◽  
Retrospective Observational Study ◽  
Lower Probability ◽  
P Value ◽  
Cgrp Receptor ◽  
Number Of Patients

Abstract Background Erenumab is a calcitonin gene-related peptide (CGRP)-receptor antibody inhibiting CGRP function. CGRP is prominently involved in the pathophysiology of migraine through nociceptive modulation in the trigeminovascular system. This study aims to explore the treatment effect of erenumab in a real-life setting. Methods In this retrospective observational study, we analyzed the data of 91 patients with migraine receiving at least three consecutive monthly injections of erenumab and followed up for 3–12 months. The primary objective was to describe the reduction in monthly migraine days throughout the follow-up period. To identify patients who responded to treatment, we analyzed the association between different patient characteristics and their treatment outcomes. Results Seventy-three patients (80.2%) responded to erenumab treatment, defined as ≥50% reduction of migraine days per month, across all migraine types. It was noted that ethnicity (p-value = 0.015) and older age (p-value = 0.035) were associated with clinically relevant improvement of symptoms. Middle Eastern ethnicity was related to less improvement of symptoms while Europeans were more likely to benefit from erenumab therapy (odds ratio: 12.788, p = 0.037). Patients aged from 31 to 40 and 41–65 years benefited most from erenumab treatment with a response rate of 77.8 and 89.9%, respectively, also confirmed by logistic regression (p = 0.047). Neither gender nor dose increase of erenumab showed association with the reported clinically relevant improvement of the symptoms. An association between clinically relevant improvement of headaches and the type of migraine was also noted. Around 87.9% of patients with episodic migraine responded to treatment, followed by 84.1% of chronic migraine patients and 50% of medication overuse headache patients. Medication overuse headache showed a lower probability of therapy success with erenumab (odds ratio: 0.126, p = 0.039). An improvement of headaches was eminent in patients who received 140 mg erenumab monthly (2 × 70 mg injections) and patients who had one injection every two weeks. Conclusions Erenumab is a novel preventive treatment for all migraine types. Clinically relevant improvement of headaches and reduction of monthly migraine days were demonstrated in patients that continued the treatment course. In real-life, a substantial number of patients suspended therapy early, reasons for which need further investigation.

scholarly journals Circaid adjustable inelastic compression wraps for the treatment of lower limb edema in the venous system pathology

2019 ◽  
pp. 12-16
Author(s):  
A. Yu. Semenov ◽  
A. M. Malakhov
Keyword(s):  
Chronic Venous Insufficiency ◽  
Western Europe ◽  
Venous Insufficiency ◽  
Medical Science ◽  
Compression Therapy ◽  
European Population ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Garments ◽  
The Usa

Symptoms of chronic venous insufficiency have been known since antiquity. The prevalence of chronic venous insufficiency in Western Europe and the USA has been reported within the range from from 1 to 40% in women and from 1 to 17% in men [1]. As reported by the European authors, the average prevalence of chronic venous insufficiency with class C2-C6 (according to the CEAP classification) among the European population reaches 30% [2]. Edema syndrome remains one of the leading manifestations of chronic venous disease. Compression therapy is one of the main ways to combat edema. The arsenal of devices for the treatment of edematous syndrome is steadily expanding with the development of medical science. Today, in addition to inelastic compression wrap and elastic compression garments, brand-new compression products, circaid adjustable inelastic compression wraps are available.

Use of a TLC-Ag dressing on 2270 patients with wounds at risk or with signs of local infection: an observational study

2020 ◽  
Vol 29 (3) ◽  
pp. 162-173 ◽  
Author(s):  
Joachim Dissemond ◽  
Michael Dietlein ◽  
Ingo Neßeler ◽  
Lutz Funke ◽  
Oliver Scheuermann ◽  
...  
Keyword(s):  
At Risk ◽  
Wound Healing ◽  
Observational Study ◽  
Chronic Wounds ◽  
Healing Process ◽  
Clinical Signs ◽  
Real Life ◽  
Wound Healing Process ◽  
Wound Infections ◽  
Local Infection

Objective: A description of wounds treated with a poly-absorbent silver dressing (with technology lipido-colloid with silver ions, TLC-Ag), and evaluation of the short-term clinical impact of the dressing on the wound healing process, under real-life conditions. Method: A large, prospective, multicentre, observational study of patients in 81 centres in Germany, presenting with an exuding wound at risk or with clinical signs of local infection for whom the evaluated TLC-Ag dressing (UrgoClean Ag, Laboratoires Urgo, France) has been prescribed. Main outcomes included: reduction in number of wound infections diagnosed and clinical signs of local infection, wound healing rate, clinical assessment of wound healing progression, relative wound area reduction (RWAR), local tolerability, handling and acceptance of the dressing. Results: A total of 2270 patients with acute and chronic wounds of various aetiologies were treated with the evaluated dressing for a mean duration of 22±13 days. All clinical signs of local infection and the diagnosed wound infections were substantially reduced at two weeks after the treatment initiation. All wound infection parameters continued to reduce until the last visit. In the meantime, clinical improvement in wound healing was reported in 98.9% of acute wounds, with a wound closure rate of 68.5%. In chronic wounds, a median RWAR of 57.4% was achieved, with an improvement in healing process documented by clinicians in 90.6% of cases, stabilisation in 6.1% and worsening in 3.2%. Similar results were reported, regardless of exudate level and proportion of sloughy and granulation tissues in the wound bed at baseline. The dressing was well tolerated and well accepted by both patients and health professionals. Conclusion: These results, documented in a large cohort of patients treated in current practice, support and complete the clinical evidence on the healing properties and safety profile of the TLC-Ag dressing in the management of wounds at risk or with clinical signs of local infection, regardless of wound and patient characteristics. Declaration of interest: This study was supported by a grant from Laboratoires Urgo. UM, EB, LT and SB are employees of Laboratoires Urgo. JD, KCM and MD provided advisory and speaking services to pharmaceutical and other healthcare organisations including, but not limited to, Laboratoires Urgo. Data management and statistical analyses were conducted independently by INPADS GmbH, Germany.

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