scholarly journals To evaluate lower extremity ulcer cases in respect of their aetiological basis

2017 ◽  
Vol 4 (3) ◽  
pp. 946
Author(s):  
Gajjam Shrinivas A ◽  
Wagh Amol

Background: Lower extremity ulcer is most common in our population due to their chronicity. Lower extremities are exposed to injury and having a circulation strained by upright posture. This has reason for researchers and surgeon who have been concerned with the reasons for their common occurrence and difficulty in their cure. Researcher interested to study the lower extremity ulcer cases in respect of their aetiological basis.Methods: 100 patients of lower extremity ulcer with various types were admitted in surgical wards of Mallareddy Institute of Medical Sciences, Hyderabad during study period.  The cases were examined in detail and investigated thoroughly.  If there is clinically doubtful case, the diagnosis was made only after histopathological examination.Results: Most common type of ulcer was found in the present was venous 25 (25%) cases, contributed by male (21) and female (04) followed by diabetic 22 (22%) and Traumatic 18 (18%). Most of cases belongs to the age group 41-60 years (45) and male (37 cases). High saphenous vein ligation with stripping of veins (21.4%) and conservative (21.4%) treatment were common surgical procedures used for the treatment of Venous ulcer.Conclusions: In the present, Venous ulcers are the most common of all leg ulcers with high morbidity. The surgical procedures are directed at prevention of venous reflux at various levels.

2019 ◽  
Vol 5 (02) ◽  
pp. 42-45
Author(s):  
Luv Luthra ◽  
Rajendra Prasad ◽  
Ranjith Kumar ◽  
Nivedita Mitta ◽  
Tinku Varghese

Abstract Introduction Nonhealing venous ulcers are one of the most common forms of lower extremity ulcers in the present population. It is cumbersome to treat and is associated with high-morbidity and immense treatment expenses. The current treatments include compression therapy. Four-layer compression dressings have proven to be an effective treatment for venous ulcers. Objective This study aimed to evaluate the efficacy of four-layer compression dressings and to study the rate of healing and duration of treatment with four-layer compression dressings. Materials and Methods A prospective randomized study conducted at MS Ramaiah Medical college which included 70 patients who completed the course of weekly dressings depending on the size of ulcer. The regular four-layer dressings were done by a trained podiatrist in vascular outpatient department (OPD) once a week. The area of the ulcer was calculated using the modified Gilmen formula. Results A total of 70 patients who were compliant with the treatment were included in the study. A considerable percentage (74%) of patients were male and all the ulcers were located at the gaiter area. Most belonged to the age group between 41 to 50 years (25%). The healing rate of ulcers at the end of 4, 8 and 12 weeks were 46.87, 28.12, and 25%, respectively. At the end of 12 weeks, all the ulcers healed.


Author(s):  
Harikrishna K.R. Nair ◽  
Xian Lew ◽  
Kong Yen Liew ◽  
Siti Aishah Kamis ◽  
Nik Muhamad Hakimi Nik Kub ◽  
...  

Background: Venous leg ulcers severely affect patients’ quality of life due to its high morbidity and recurrent nature. Currently, compression therapy is the first-line treatment for venous leg ulcers. Aim: This study sought to evaluate the efficacy of the Mobiderm® technology developed by Thuasne in a prospective case series of venous leg ulcers. Methods: Nine patients ( N  =  9) with venous leg ulcers were enrolled into this case series. Mobiderm® bandage was applied on to the affected limbs of the patients in the multi-component bandages system. The bandages were changed as frequent as the patients had their wound dressing for their standard treatment in a 12-week duration. Wound size and calf circumference were measured at week 0 and week 12. Paired sample t-test was used to compare the mean values of wound size and calf circumference pre- and post-treatment. Results: Reductions in wound size and calf circumference were observed in all nine patients (100%). Five patients were evaluable at week 12. The wound sizes significantly reduced by 27.2% to 53.2% ( p  =  0.02), and the calf circumferences significantly reduced by 3.2% to 26.0% ( p  =  0.02) after 12 weeks ( N  =  5). Safety was unremarkable, with no occurrence of treatment-emergent-related adverse event. Conclusion: Mobiderm® bandage was reported to be effective in promoting wound healing and reducing swelling, suggesting it to be integrated in the compression therapy for the management of venous leg ulcers.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0024
Author(s):  
Leah Herzog ◽  
Charles Johnson ◽  
Christopher E. Gross

Category: Trauma Introduction/Purpose: Currently there is minimal focus on traumatic lower extremity amputations due to their relatively low incidence, but they often come with a higher morbidity and mortality than its upper extremity counterparts. The purpose of this study was to evaluate the incidence and trends of lower extremity amputations in the United States over a ten-year period. Methods: The National Electronic Injury Surveillance System (NEISS), was used for evaluation of lower extremity amputations that presented to the United States emergency departments. The overall incidence rate of lower extremity amputations within the United States was calculated as per 100,000 persons. After grouping mechanisms of injury, the data were stratified by both age groups and gender. Chi-square tests were used for direct comparisons of proportions. The five most common mechanisms were ranked for each age group and the most common overall age group for lower extremity amputations were determined using descriptive statistics. Trends for injury incidence and hospital admissions were evaluated using linear regression and Pearson correlation with Bonferroni correction. Results: From 2008 to 2017, 393 patients were reported to have sustained lower extremity amputations via the NIESS database with an estimated 11,475 patients sustaining a lower extremity amputation over the past ten years and an incidence of 2.2/100,000 person-years. The incidence of lower extremity amputations is highest in those less than five years old. Lawnmower incidents are the most common mechanism of injury in all age groups. Conclusion: Due to the high morbidity and mortality associated with these injuries, it is prudent to follow the trends in lower extremity amputations.


Author(s):  
Anand Sankar Sastry ◽  
Buridi Praneetha

Background: Hyponatremia, most common electrolyte disorder has symptomatology ranging from asymptomatic to being comatose and etiologically from simple G.I. loss to chronic illnesses like CCF, CKD. Very sparse study has been done in this region on clinic-epidemiological profile of hyponatremia. The aims and objective of this study was to find out most common etiology, type, clinical features and outcome in hospitalised hyponatremic patients and to Correlate clinical profile and outcome with etiology, severity and treatment.Methods: The present observational study was conducted in department of medicine, Maharajah’s Institute of medical sciences, for two months. All patients aged ≥15 years having true hyponatremia were included. Detailed history, examination, relevant investigations including serum and urinary Na were done. Patients were classified to euvolemic, hypervolemic and hypovolemic depending on volume status and proper etiologies were determined in each group.Results: Of 50 patients included, mean age was 50.12±8.8 years. Hyponatremia was more common in older age group>40 years (P<0.05%). CNS manifestations were more prevalent in patients with Na<125 Meq. (80%) P< 0.05%. Hypervolemic was most common type (50%) followed by hypovolemic (34%) and euvolemic (16%). CKD was the most common cause overall (24%) and also among hypervolemic type (40%).Conclusions: Hyponatremia was more predominant in elderly age group (P<0.05%). It is more in 40-60 years age group. Hypervolemic type (50%) of hyponatremia is most common type of the hyponatremia and CKD (24%), to be most common cause of the hyponatremia attributed to Uddanam nephropathy in this region.


Phlebologie ◽  
2008 ◽  
Vol 37 (04) ◽  
pp. 191-197 ◽  
Author(s):  
V. Mattaliano ◽  
G. Mosti ◽  
V. Gasbarro ◽  
M. Bucalossi ◽  
W. Blättler ◽  
...  

SummaryTraditionally, venous leg ulcers are treated with firm nonelastic bandages. Medical compression stockings are not the first choice although comparative studies found them equally effective or superior to bandages. Patients, methods: We report on a multi-center randomized trial with 60 patients treated with either short stretch multi-layer bandages or a two-stocking system (Sigvaris® Ulcer X® kit). Three patients have been excluded because their ankle movement was restricted to the extent that they could not put on the stockings and 1 patient withdrew consent. Patient characteristics and ulcer features were evenly distributed. The proportion of ulcers healed within 4 months and the time to completion of healing were recorded. Subjective appraisal was assessed with a validated questionnaire. Results: Complete wound closure was achieved in 70.0% (21 of 30) with bandages and in 96.2% (25 of 26) with the ulcer X kit (p = 0.011). Ulcers with a diameter of up to about 4cm healed twice as rapidly, the larger ones as fast with the stocking kit as with bandages. The sum of problems encountered with bandages was significantly greater than that observed with the stocking kit (p < 0.0001). Pain at night and in the morning was absent with stockings but reported by 40% and 20% in the bandage group, respectively. The cardinal features associated with delayed or absent healing were ulcer size and pain. Conclusions: Common venous ulcers can readily be treated with the ulcer X compression kit provided the ankle movement allow its painless donning. Bandages, even when applied by the most experienced staff are less effective and cause more problems.


Author(s):  
Amna Mohamed Ahmed ◽  
Towmader Awad ◽  
Hajer Yousif ◽  
Reem Nahari ◽  
Omnia Abdelrhman ◽  
...  

Computed Tomography (CT) is the most commonly used imaging modality in the evaluation of cerebral hemorrhage in the head trauma patients. Objective: To study the incidence of a cerebral hemorrhage in traumatic patients using computed tomography. Method: This retrospective study was conducted at King Khalid hospital in Tabuk city, Saudi Arabia, in the radiology department, in the period from September 2018 to April 2020. The study was done by collecting 471 CT reports of patients all of them were exposed to head trauma with deferent reasons. The data were analyzed by Statistical Package for the Social Sciences (SPSS) program (ver. 20) and presented in tables and graphs according to the checklist which includes: patient age, gender, type of trauma, CT finding, and type of hemorrhage. Results: The most age group suffered from head trauma was less than 20 years percentage (55%), The male patients more exposed to head trauma than female patients with percentage (84.5%), the road traffic accident (RTA) is the most common type of trauma by percentage (63.5%), according to the CT finding; the cerebral hemorrhage represented (15.5%) with the highest percentage in a subdural hematoma (31.2%), the fracture represented (2.8%) while the normal appearance represented (81.7%) as the highest percentage. Conclusion: Most of the traumatic brain injury in patients caused cerebral hemorrhage and the CT scan reports show that: the common type of cerebral hemorrhage is subdural hematoma and it is common in males which exposed to (RTA) in the age group (21 - 40) years old.


2000 ◽  
Vol 4 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Aditya K. Gupta ◽  
Joel De Koven ◽  
Robert Lester ◽  
Neil H. Shear ◽  
Daniel N. Sauder

Background: Venous ulcers are increasing in prevalence, especially since these are observed more frequently in the elderly, and the number of individuals in this age group is becoming a larger portion of the population. Objective: To determine the healing rate and safety of the Profore™ Extra Four-Layer Bandage System in the management of venous leg ulcers. Methods: In an open-label study, patients aged 18 years or older with venous leg ulcers were treated with a high compression four-layer bandage system in which a hydrocellular dressing was placed in contact with the wound. The combination is designated the “Profore Extra Four-Layer Bandage System.” Follow-up visits took place weekly unless there was heavy exudation from the ulcer or if there was marked edema of the leg at the start of the study requiring reapplication of the bandage system. Results: Fifteen patients were entered into the study (men 8, women 7, mean age 66 years, mean duration of ulcers 1.3 years). Thirteen of the 15 patients completed the study, with two withdrawals. In one patient who withdrew, the ulcer became infected and required treatment with antibiotics. The other termination from the study occurred for reasons unrelated to treatment. The ulcer in this patient healed in 7 weeks. Ten of the 13 patients (77%) who completed the study, and 10 (67%) of 15, who had enrolled experienced complete (100%) healing. Healing of > 80% of the ulcers occurred in 11 of 13 patients (85%) who completed the study and in 12 (80%) of 15 enrolled patients. No patient experienced a study-related adverse event. One patient developed contact dermatitis and was later found to have stasis dermatitis. It is unclear whether the initial event was contact or stasis dermatitis. Conclusion: In this open-label study, a high compression system, using the Profore Extra Four-Layer Bandage with a hydrocellular dressing in contact with the wound, was found to be effective and safe for the treatment of venous leg ulcers.


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.


Author(s):  
Aaron R. Dezube ◽  
Jake Rauh ◽  
Michael Dezube ◽  
Mark Iafrati ◽  
JoAnn Rigo ◽  
...  

AbstractRestless leg syndrome (RLS) is a common cause of lower extremity discomfort. We hypothesized that patients with RLS symptoms have higher rates of deep and superficial venous reflux (SVR). Retrospective review of patients ≥18 years of age evaluated in a venous center from December 2018 to February 2019. Differences in rates of RLS symptoms, demographics, comorbidities, and clinical and radiologic presence of venous disease were analyzed. Overall, 207 patients were analyzed; 140 (67.6%) reported RLS symptoms (n = 25 with prior RLS diagnosis). RLS symptoms were more common with superficial or combined superficial and deep venous reflux (DVR) compared with those without reflux (p < 0.001). Patients with RLS symptoms as opposed to those without had similar demographics and comorbidities (all p > 0.05) but increased rates of venous pain, phlebitis, family history of venous disease, lower extremity swelling and SVR, and combined SVR and DVR (all p < 0.05). Our multivariable logistic regression found presence of SVR, and family history of venous reflux was associated with RLS symptomatology (all p < 0.001). Ninety-nine patients with RLS underwent ablation; of them, 93 had duplex-proven reflux resolution of which 81 (87%) reported RLS symptom improvement. This included 13 of 16 (81.3%) with prior RLS diagnosis. SVR is associated with increased rates of RLS symptoms in a vein center population. Therefore, RLS symptoms should trigger a targeted venous evaluation. Our results suggest that venous ablation may lead to resolution of RLS symptoms in patients with SVR, but randomized prospective trials with strict RLS definition criteria are warranted to confirm these outcomes.


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