scholarly journals Veninių trofinių opų priežastys ir gydymo ypatumai

2003 ◽  
Vol 1 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Ingrida Gudgalytė
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Adult Population ◽  
Local Treatment ◽  
Leg Ulcer ◽  
University Hospital ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Rational Treatment ◽  
Occlusive Dressings

Ingrida GudgalytėVilniaus universiteto Bendrosios ir kraujagyslių chirurgijos klinika Įvadas / tikslai Pateikti sergančių lėtiniu veniniu nepakankamumu ir trofine opa socialinę-ekonominę charakteristiką; išanalizuoti trofinių opų priežastis, ligos eigą, kliniką; pateikti veninės kilmės trofinių opų racionalaus gydymo rezultatus; palyginti juos su rezultatais, kai opa buvo gydoma neracionaliais metodais; apskaičiuoti neracionalaus gydymo išlaidas ir palyginti su išlaidomis, kai ligoniai buvo gydomi pagal šiuolaikinius reikalavimus ir Tarptautinį susitarimą; įdiegti Lietuvoje antirefliuksinio ir fiziologinio opos gydymo protokolus ir metodus. Metodai Buvo tiriami Vilniaus universiteto Kraujagyslių chirurgijos klinikoje 1999–2002 m. gydyti ir stebėti 164 ligoniai, sergantys veninės kilmės trofinėmis opomis. Rezultatai Nuo pirminės venų varikozės gydyta 147 (89,63 %) ligoniai, nuo potrombozinio sindromo – 17 (10,36 %). Ligonių amžius – 30–82 metai. Vyrų buvo 57 (35 %), moterų – 107 (65 %). Veninės kilmės trofinių opų trukmė – nuo 2 savaičių iki 48 metų (vid. 12 m.). Tyrimo metu 157 ligoniams (95,73 %) buvo odos pokyčių, būdingų aktyviai opai, 7 ligoniams (4,26 %) opos buvo užgijusios. Opų dydis svyravo nuo 0,5 cm iki 20 cm. Penki (3,06 %) ligoniai gydyti nuo žiedinių opų. Infekuotos trofinės opos gydytos 63 ligoniams (38,41 %), 101 ligoniui (61,59 %) opos buvo be infekcijos požymių. Analizuojant gydymą iki stacionaro nustatyta, jog opos buvo gydomos netinkamai: antirefliuksinis gydymas arba buvo visai netaikytas, arba buvo netinkamas; lokaliai opos buvo gydomos vaistais, stabdančiais opos gijimą – antibakteriniais tirpalais, tepalais, net 85 (52 %) ligoniai opas gydėsi pseudoliaudiškomis priemonėmis (maistiniu aliejumi, zuikio taukais ir t. t.). Kraujagyslių chirurgijos klinikoje opų priežasčiai nustatyti ligoniams buvo atliekamas dvigubas skenavimas; taikytas radikalus antirefliuksinis gydymas (flebektomija ir suprafascijinis perrišimas, flebektomija ir subfascijinis kiūrančių venų perrišimas, sub- ir suprafascijinis kiūrančių venų perrišimas), kompresinė terapija trumpo tempimo tvarsčiais, lokaliai opos gydytos hidrokoloidiniais tvarsčiais. Opos gydymas stacionare truko vidutiniškai 12 dienų. Po operacijos vidutinė opos gijimo trukmė – 2 savaitės (1 sav. – 6 mėn.). Po gydymo ligoniai stebėti 12 mėn., opos užgijo 145 (88 %) ligoniams, sumažėjo 10 (6,1 %), liko tokio paties dydžio 2 (1,22 %), padidėjo 7 (4,27 %). Opos gydymui per metus ligonis išleisdavo 600–3600 litų. Gydant racionaliai (operacija, kompresinė terapija, hidrokoloidiniai tvarsčiai), gydymo išlaidos sumažejo iki 240 litų. Išvados Dažniausia trofinių opų priežastis – paviršinių venų varikozė (89 %). Tyrimas ultragarsu leidžia tiksliai nustatyti refliukso priežastį. Opos gydytos kompleksiškai (radikalus chirurginis gydymas, kompresinė terapija, vietinis fiziologinis gydymas). Gydant racionaliais metodais 88 % ligonių opos užgijo per 1 mėnesį. Racionalus gydymas 7–10 kartų pigesnis. Prasminiai žodžiai: venos, lėtinis venų nepakankamumas, opos. Causes and management of venous ulcers Ingrida Gudgalytė Background / objective The aim is to create and introduce algorithms of treatment of venous leg ulcer in Lithuania. Venous leg ulcer is one of the most severe complications of chronic venous insufficiency. It affects 1% of the adult population. It could be about 8000 patients with leg ulcers in Lithuania.. Methods In the period 1999–2002, in the Department of Vascular Surgery of Vilnius University Hospital 164 patiens were operated on for venous leg ulcers. Results 147 (89%) patients were treated for primary venous varicose and 17 (11%) had posttrombose syndrom. The leg ulcer disease took the period from one month to 48 years. 72.56% of patiens spent 25% of income on treatment and medicines. The ulcers were diagnosed with ultrasound. The patients had a rational treatment: surgical, compressing therapy and occlusive dressings as the local treatment. Conclusions 37.2 % of ulcers were cured within 1–3 weeks, 88% of them were cured completely. In the rational treatment (operation, compressing therapy, occlusive dressings) the cost on treatment covers up to 240 Lt, while the expeditures on irrational treatment reach 1778–2376 Lt per year. The rational treatment is 7–10 times cheaper. Keywords: veins, chronic venous insufficiency, ulcers.

scholarly journals Translation and cross-cultural adaptation of the Venous Leg Ulcer Self Efficacy Tool for use in a Swiss-French setting

2020 ◽  
Vol 21 (Issue 1 Volume 21, 2020) ◽  
pp. 7-10
Author(s):  
Mathieu Turcotte ◽  
Monika Buehrer Skinner ◽  
Sebastian Probst
Keyword(s):  
Cultural Adaptation ◽  
Chronic Venous Insufficiency ◽  
Self Efficacy ◽  
Venous Insufficiency ◽  
Cross Cultural ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Cross Cultural Adaptation ◽  
Venous Leg Ulcers

Venous leg ulcers are lesions between the ankle joint and the knee caused by chronic venous insufficiency. The Venous Leg Ulcer Self Efficacy Tool (VeLUSET) was developed to measure self-care and self-efficacy in Englishspeaking persons with venous leg ulcers. This study describes the translation and cross-cultural adaptation of the original version of the VeLUSET from English into Swiss French.

Clinical Benefits of Daflon 500 mg in the Most Severe Stages of Chronic Venous Insufficiency

Angiology ◽  
2001 ◽  
Vol 52 (1_suppl) ◽  
pp. S49-S56 ◽  
Author(s):  
Albert Adrien Ramelet
Keyword(s):  
Chronic Venous Insufficiency ◽  
Mode Of Action ◽  
Venous Insufficiency ◽  
Standard Treatment ◽  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Skin Changes ◽  
Inflammatory Reactions ◽  
Randomized Controlled Studies ◽  
Clinical Benefits

Chronic venous insufficiency (CVI) affects a large number of people in Western countries, and is responsible for considerable inconvenience, discomfort, suffering, and costs. Micronized purified flavonoid fraction (MPFF, 450 mg diosmin plus 50 mg hesperidin- Daflon 500 mg) is a potent venotropic drug used in the treatment of venous insufficiency. Pharmacological and clinical studies demonstrated the comprehensive mode of action of Daflon 500 mg: it increases venous tone, it improves lymph drainage, and it protects the microcircu lation. Clinical international, prospective, multicenter, randomized, controlled studies versus placebo studies documenting the effects of Daflon 500 mg in CVI at advanced stages with edema, skin changes, and venous leg ulcer are reviewed. In edema, one of the most frequent complaints of patients, Daflon 500 mg brings about a significant reduction in leg circumference, thanks to its capacity to inhibit inflammatory reactions and to decrease capillary hyperper meability. The rationale for the use of Daflon 500 mg for treatment of skin disorders and venous leg ulcer is its action on the microcirculation-damaging processes. Regarding skin changes, Daflon 500 mg has been shown to improve venous trophic disorders, like gravitational (stasis) dermatitis, and dermatofibrosclerosis. In venous leg ulcer, Daflon 500 mg's clinical efficacy has been demonstrated in addition to standard treatment or versus standard treatment alone. Daflon 500 mg, thanks to its comprehensive mode of action on the veins, lymphatics, and microcirculation, is the method of choice not only in the early stages of CVI treatment, but also in the severe stages of this condition, in combination with compression treatment, scle rotherapy, and surgery if appropriate.

Autologous cultured single-keratinocytes in fibrin glue suspension in chronic venous leg ulcers

Phlebologie ◽  
2001 ◽  
Vol 30 (02) ◽  
pp. 44-47 ◽  
Author(s):  
J. Waler ◽  
A. Franek ◽  
B. Gierat-Kucharzewska ◽  
M. Kucharzewski
Keyword(s):  
Fibrin Glue ◽  
Venous Insufficiency ◽  
Leg Ulcer ◽  
Ulcer Formation ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Venous Leg Ulcers ◽  
Rapid Healing ◽  
Skin Specimen ◽  
Chronic Leg Ulcers

SummaryThe aim of this work was to apply the cultured autologous keratinocytes in fibrin glue suspension in treatment of chronic non-healing venous leg ulcers. 32 patients with chronic leg ulcers caused by venous insufficiency were treated. The surface of ulcers covered 14.2 cm2 to 48.6 cm2. The duration of leg ulcer was between 4 to 20 years. The skin specimen 1.0 × 1.0 cm was taken from the buttock of each patient, from which keratinocytes were obtained. Next those cells were cultured. After 7 days the keratinocytes in fibrin glue were applied to the wound bed. After 2 weeks of treatment the ulceration of 13 patients healed completely whereas the ulcer formation of the rest of the patients diminished by 30%. In all patients the process of healing was successfully completed after further 4 weeks. Our method shows that a rapid healing chronic venous leg ulcer can be achieved by keratinocytes in fibrin glue suspension.

scholarly journals Protocol for a longitudinal cohort study: determination of risk factors for the development of first venous leg ulcer in people with chronic venous insufficiency, the VEINS (venous insufficiency in South Florida) cohort

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023313 ◽  
Author(s):  
Joshua S Mervis ◽  
Robert S Kirsner ◽  
Hadar Lev-Tov
Keyword(s):  
Risk Factors ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Adult Population ◽  
South Florida ◽  
Study Endpoint ◽  
Venous Leg Ulcer ◽  
Doppler Study ◽  
Vascular Laboratory ◽  
The University

IntroductionChronic venous insufficiency (CVI) affects up to one-third of the adult population yet venous leg ulcers (VLU), a significant complication of CVI, only affect 1%–2% of adults in the USA. Why some develop VLU and others do not is unclear. VLU have a significant impact on quality of life and are extremely costly and difficult to treat. Moreover, VLU prevalence is increasing, doubling in the last 20 years. In order to characterise the differences between people with CVI and those who ultimately develop VLU, we aim to set up the unique venous insufficiency in South Florida cohort.Methods and analysisSubjects will be recruited from the University of Miami Hospital and Clinic’s vascular laboratory database, which began in July 2011. Any adult age 18–95 who has had venous reflux detected on duplex ultrasound of the lower extremities is included. Approximately 2500 patients are already in the database that meet these criteria, with an estimated 2500 additional potential subjects to be recruited from the vascular laboratory database over the next 5 years. Subjects with a history of VLU prior to the duplex study date will be excluded. Data will be collected via review of the Doppler study report, patient phone interview and review of the electronic medical record. Subjects will be contacted for follow-up every 3 months for at least 5 years until the study endpoint, development of first VLU (fVLU), is reached. In order to estimate the time from reflux documentation to fVLU, Kaplan-Meier survival curves will be constructed. Cox proportional hazard regression models will be constructed to investigate possible risk factors.Ethics and disseminationThis study is approved by the University of Miami’s Institutional Review Board. We hope to present the results of this study to the scientific community at conferences and in peer-reviewed journals.

Contact allergy in patients with chronic venous leg ulcers - possible role of chronic venous insufficiency

2006 ◽  
Vol 54 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Maria Zmudzinska ◽  
Magdalena Czarnecka-Operacz ◽  
Wojciech Silny ◽  
Lucyna Kramer
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Contact Allergy ◽  
Leg Ulcers ◽  
Venous Leg Ulcers

Changes in Microcirculation in Venous Ulcers with Essaven Gel

Angiology ◽  
2001 ◽  
Vol 52 (3_suppl) ◽  
pp. S23-S27 ◽  
Author(s):  
L. Incandela ◽  
G. Belcaro ◽  
M.R. Cesarone ◽  
M.T. De Sanctis ◽  
M. Griffin
Keyword(s):  
Placebo Group ◽  
Treatment Group ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Local Treatment ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Single Application ◽  
Venous Ulcers

Microcirculatory changes in chronic venous insufficiency (CVI) due to venous hypertension produce venous hypertensive microangiopathy (VHM) and lead to ulceration. VHM is charac terized by enlarged, convoluted capillaries; increase in flux, permeability, and edema; and altered microlymphatics. PO2 is decreased and CO2 increased. Capillary exchanges are altered and nutritional alterations in association with microtrauma may cause venous ulcers. The aim of this pilot, cross-over, randomized, placebo-controlled study was to evaluate the effect of local treatment with Essaven gel (EG) (single acute application) in 10 subjects with VHM and venous ulcers. The study was structured over 3 days: day 1 was used for the control evalua tion for all patients. One group was randomized for the sequence placebo (day 2) and EG the following day; the second group with the sequence EG (day 2) and placebo (day 3). Indepen dently from the sequence, measurements of flux and PO2 in standard conditions showed positive changes (significant decrease of the abnormally increased flux, PO2 increase) in the EG treatment group. Changes in the placebo group were limited and associated with skin manip ulation. In conclusion, EG acutely improves microcirculation in limbs with VHM and ulceration even with a single application.

scholarly journals FTIR spectroscopy of chronic venous leg ulcer exudates: an approach to spectral healing marker identification

The Analyst ◽  
2018 ◽  
Vol 143 (7) ◽  
pp. 1583-1592 ◽  
Author(s):  
Nicolas Cerusico ◽  
Juan P. Aybar ◽  
Silvana Lopez ◽  
Silvia G. Molina ◽  
Romina Chavez Jara ◽  
...  
Keyword(s):  
Ftir Spectroscopy ◽  
Venous Insufficiency ◽  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Marker Identification

Chronic venous leg ulcer arises as a venous insufficiency complication and is a cause of great morbidity.

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

2019 ◽  
Vol 34 (8) ◽  
pp. 501-514 ◽  
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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