scholarly journals Extracorporeal Shockwave Therapy for Chronic Venous Ulcers: A Randomized Controlled Trial

2021 ◽  
Vol 10 ◽  
pp. 1931
Author(s):  
Parisa Taheri ◽  
Morteza Shahbandari ◽  
Mehrnoosh Parvaresh ◽  
Babak Vahdatpour
Keyword(s):  
Health Care Systems ◽  
Controlled Trial ◽  
Healing Process ◽  
Venous Ulcer ◽  
Control Group ◽  
Shockwave Therapy ◽  
Venous Ulcers ◽  
Lower Pain ◽  
Care Systems ◽  
Treatment Of Wounds

Background: Chronic venous ulcers (CVUs), demanding specialized care, are still a major socioeconomic problem facing health care systems worldwide. This study’s main goal was evaluating the efficacy of ESWT application as an AT in the treatment of wounds for curing CVUs. Materials and Methods: 50 patients presenting with CVUs were divided into two groups of ESWT and control randomly. Then, ESWT was applied one session per week, during four weeks, along with routine CB. The control group also received sham ESWT together with CB. In this respect, pain score, wound size, patient satisfaction and quality of life (QoL) using the Charing Cross Venous Ulcer Questionnaire (CCVUQ) were consequently assessed at baseline, week four, and week eight and then compared between both groups. Results: The findings showed that patients receiving ESWT along with CB had significantly lower pain and were also feeling more satisfied than the cases undergoing CB alone (P<0.05). The significant efficiency of ESWT in improving the healing process of CVUs was further observed (P<0.05). In addition, QoL, assessed by the CCVUQ, was significantly higher in patients receiving ESWT (P<0.05). Conclusion: These findings established that ESWT was a feasible and safe option to treat patients presenting with CVUs in another word, ESWT seems to be a safe and effective adjunct therapy (AT) compared with CB in patients with CVUs. [GMJ.2021;10:e1931]

scholarly journals Naprapathy Versus Orthopaedic Standard Care for Common Musculoskeletal Disorders: An 8-year Follow-up of a Pragmatic Randomized Controlled Trial in Sweden

2021 ◽  
Author(s):  
Stina Lilje ◽  
Andreas Eklund ◽  
Anders Wykman ◽  
Tobias Sundberg ◽  
Eva Skillgate
Keyword(s):  
Health Care ◽  
Musculoskeletal Disorders ◽  
Health Care Systems ◽  
Controlled Trial ◽  
Bodily Pain ◽  
Control Group ◽  
National Health Care ◽  
Care Systems ◽  
Experimental Group

Abstract Background: Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a complementary therapy for common orthopaedic disorders.Methods: An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists(n=78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected.Results: N=75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21,7 (95% CI: 9,1-34,3)), physical function (17,6(6,7-28,4)), and QoLs (0,823 (95% CI: 0.785-0.862) compared with 0,713 (95% CI: 0.668-0.758)) were statistically significantly in favor of the experimental group (p-values<0,01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1 161 in the control group.Conclusions:Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems.Trial registration: Not applicable, as per information given by ClinicalTrials.gov.

scholarly journals Efficacy of bacterial cellulose membrane for the treatment of lower limbs chronic varicose ulcers: a randomized and controlled trial

2017 ◽  
Vol 44 (1) ◽  
pp. 72-80 ◽  
Author(s):  
LUCIANA MARINS CAVALCANTI ◽  
FLÁVIA CRISTINA MORONE PINTO ◽  
GLÍCIA MARIA DE OLIVEIRA ◽  
SALVADOR VILAR CORREIA LIMA ◽  
JOSÉ LAMARTINE DE ANDRADE AGUIAR ◽  
...  
Keyword(s):  
Bacterial Cellulose ◽  
Controlled Trial ◽  
Health Department ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Controlled Study ◽  
Control Group ◽  
Cellulose Membrane ◽  
Ulcer Disease ◽  
Venous Ulcers

ABSTRACT Objective: to evaluate the efficacy of Bacterial Cellulose (BC) membrane dressings in the treatment of lower limb venous ulcers. Methods: we carried out a prospective, randomized, controlled study of 25 patients with chronic venous ulcer disease in the lower limbs from the Angiology and Vascular Surgery Service of the Federal University of Pernambuco Hospital and from the Salgado Polyclinic of the County Health Department, Caruaru, Pernambuco. We randomly assigned patients to two groups: control group, receiving dressings with triglyceride oil (11 patients) and experimental group, treated with BC membrane (14 patients). We followed the patients for a period of 120 days. Results: There was a reduction in the wound area in both groups. There were no infections or reactions to the product in any of the groups. Patients in the BC group showed decreased pain and earlier discontinuation of analgesic use. Conclusion: BC membrane can be used as a dressing for the treatment of varicose ulcers of the lower limbs.

scholarly journals Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Stina Lilje ◽  
Andreas Eklund ◽  
Anders Wykman ◽  
Tobias Sundberg ◽  
Eva Skillgate
Keyword(s):  
Health Care ◽  
Musculoskeletal Disorders ◽  
Manual Therapy ◽  
Health Care Systems ◽  
Controlled Trial ◽  
Bodily Pain ◽  
Control Group ◽  
Care Systems ◽  
Experimental Group

Abstract Background Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a manual therapy (naprapathy) for common orthopaedic disorders. Methods An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists (n = 78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected. The treatments lasted from January 2007 to November 2007. Results N = 75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21.7 (95% CI: 9.1–34.3)), physical function (17.6 (6.7–28.4)), and QoLs (0.823 (95% CI: 0.785–0.862) compared with 0.713 (95% CI: 0.668–0.758)) were statistically significantly in favor of the experimental group (p-values < 0.01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1161 in the control group. Conclusions Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems. Trial registration: Not applicable, as per information given by ClinicalTrials.gov.

scholarly journals Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS

2019 ◽  
Vol 11 (2) ◽  
pp. 110
Author(s):  
Ekanova R. N. Sumarauw ◽  
Mendy J. Hatibie ◽  
Djony E. Tjandra ◽  
Fredrik G. Langi
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Controlled Trial ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Wound Healing Process ◽  
Holistic Treatment ◽  
The Third

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik

scholarly journals ROLE OF PLATELET RICH PLASMA IN TREATMENT OF CHRONIC NON-HEALING VENOUS ULCER

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Firdaus A. Dekhaiya ◽  
Jignesh K. Joshi ◽  
Sarav Bamania
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Healing Process ◽  
Venous Ulcer ◽  
Lower Limbs ◽  
Venous Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Adhesive Proteins ◽  
Autologous Platelet

Introduction: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the lower limbs. Considering that PRP is a source of growth factors, and consequently has mitogenic, angiogenic, and chemotactic properties, it represents an adjunctive treatment for recalcitrant wounds. Moreover, PRP provides the wound with adhesive proteins, such as fibrinogen, which are important in wound healing. PRP contain more amount of platelets, cytokines and growth factors which are dispersed in a very small amount of plasma which can be prepared from a sample of centrifuged autologous blood. Application of PRP has been reported to be effective in both acute as well as chronic non healing venous ulcers. Aim and Objective: To evaluate the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Material and Method: A Prospective study conducted on 100 patients of chronic venous ulcers admitted in Sir T. Hospital Bhavnagar from June 2018 to June 2019 after fulfilled our inclusion and exclusion criteria. PRP then injected intalesionally inside and around the periphery of the wound/ulcer. This process was done once/week for 12 weeks. At every week, the area and volume of ulcer was calculated and photographs were taken. Result: All the patients showed healing of the ulcer with reduction in size of ulcer more than 90% was observed in 72 patients, followed by 80–90% reduction in wound size in 18 patients after the 12 weeks follow-up. Overall, significant reduction in size of ulcer was observed in all the treated patients. Conclusion: Autologous platelet rich plasma (PRP) as an autologous method, it is biocompatible, simple, safe, affordable and less expensive procedure in the treatment of chronic venous ulcers. PRP is found to be useful in improving and enhancing the healing process in chronic venous leg ulcers without any side effect. Keywords:  Venous ulcer, Platelet rich plasma

860 Impact of Orally Administered Tramadol Combined with Self-selected Music on Adult Outpatients with Burns Undergoing Dressing Change: A Randomized Controlled Trial

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S267-S268
Author(s):  
Xiu-Hang Zhang ◽  
Jia-Ao Yu ◽  
Xin-Xin Chen
Keyword(s):  
Wound Healing ◽  
Primary Outcome ◽  
Short Form ◽  
Controlled Trial ◽  
Healing Process ◽  
Total Body Surface Area ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Wound Healing Process ◽  
Dressing Change

Abstract Introduction Burn injuries have significant physiological and psychological consequences. Dressing changes have been considered the most painful among all non-surgical procedures. Anxiety, which is closely associated with pain, is a part of the burn and wound-healing process and can cause delays in wound healing and recovery procedures. In addition, anxiety may have a devastating mental and physical influence on patients.What’s more,patients whose symptoms were not adequately alleviated are likely to suffer more in their subsequent dressing changes. Pharmacological treatment is the primary approach for relieving pain and anxiety related to burns. In comparison with traditional analgesics, tramadol is a more manageable drug under clinical conditions. However, due to the variability of the intensity of pain and anxiety in patients, the two symptoms remain under-treated. Recently, much attention has been paid to pain management approaches that combine pharmacological treatments with non-pharmacological therapies. In this regard, this study was designed to analyze the effect of tramadol and its combination with self-selected music on burn patient. Methods To investigate the effects of music and/or tramadol on pain and anxiety in burn outpatients undergoing dressing changes. Patients (N = 180) with burns on up to 10%-30% of the total body surface area (TBSA). The patients were selected using a convenience sampling method and randomly allocated to 4 equal-sized groups as follows: 1) tramadol group (TG), patients received 100 mg of tramadol orally 20 min before the dressing change; 2) music group (MG), patients listened to self-selected music during the dressing change; 3) music-plus-tramadol group (MTG), patients received tramadol and listened to self-selected music; and 4) control group (CG), patients received a routine dressing change only. All patients underwent the interventions once per day for 2 days. McGill Pain Questionnaire Short Form (MPQ-SF) (primary outcome), McGill Pain Persian version of Burn Specific Pain Anxiety Scale (BSPAS) (primary outcome), and heart rate (HR) and overall patient satisfaction (secondary outcomes). Results The results showed that MTG had better outcomes with respect to pain and anxiety management during dressing changes. Conclusions In comparison with music or tramadol alone, the integration of music and tramadol offers a secure and favorable treatment choice to relieve pain and anxiety, ultimately improving the satisfaction levels of burn outpatients during dressing changes. Applicability of Research to Practice The findings showed that the combined approach was more effective in reducing pain and anxiety among the outpatients, as the findings outline the potential use of this technique in the management of dressing changes in burn outpatients.

Failure of a trial evaluating the effect of venous surgery on healing and recurrence rates in venous ulcers? The USABLE trial: rationale, design and methodology, and reasons for failure

2004 ◽  
Vol 19 (3) ◽  
pp. 137-142 ◽  
Author(s):  
A H Davies ◽  
A J Hawdon ◽  
R M Greenhalgh ◽  
S Thompson
Keyword(s):  
Controlled Trial ◽  
Venous Ulcer ◽  
Recurrence Rates ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Number Of Patients ◽  
Venous Surgery ◽  
Ulcer Surgery ◽  
Set Up

Objective: This Medical Research Council funded trial was set up to investigate whether venous surgery provided any additional benefit in the healing and recurrence rates of venous ulcers over compression bandaging alone. Methods: Ulcer surgery as adjuvant to compression bandaging for leg ulcers (USABLE) was a multicentre, randomized controlled trial, which planned to recruit 1000 venous ulcer patients to receive either compression bandaging alone or compression bandaging plus venous surgery. Follow up recorded ulcer healing, recurrence and patient quality of life. Results: Recruitment was slow, and involved screening a large number of patients (759) with only 75 randomized over an 18-month recruitment period. Conclusions: The results would infer that surgery is unlikely to be a management option for the majority of patients presenting to a hospital with a gaiter area leg ulcer.

scholarly journals Evaluating the effectiveness of the customized Unna boot when treating patients with venous ulcers*

2013 ◽  
Vol 88 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Bruna Suelen Raymundo Luz ◽  
Cristina Souza Araujo ◽  
Dênia Amélia Novato Castelli Von Atzingen ◽  
Adriana Rodrigues dos Anjos Mendonça ◽  
Marcos Mesquita Filho ◽  
...  
Keyword(s):  
Lower Limb ◽  
Chronic Wound ◽  
Wound Care ◽  
Subsequent Development ◽  
Venous Ulcer ◽  
Control Group ◽  
Wound Area ◽  
Venous Ulcers ◽  
The World ◽  
The City

BACKGROUND: Lower limb ulcers are a serious medical and socioeconomic problem throughout the world. One type of chronic wound of the lower extremities is the venous ulcer. Therapeutic methods for treating venous ulcer include the use of the Unna boot. OBJECTIVES: To evaluate the effectiveness of the customized Unna boot in the treatment of venous ulcers and to monitor the subsequent development and healing of the lesions. METHODS: Prospective exploratory and quantitative longitudinal study, conducted at the "Outpatients Department (Wound Care) of the Grupo da Fraternidade Espírita Irmão Alexandre" in the city of Pouso Alegre (MG), Brazil, in 2008. The sample consisted of 32 patients with venous ulcers who underwent treatment with the Unna boot and 11 patients (control group), who used a simple bandage application. The patients'lesions were monitored over a three month period. RESULTS: The average age of the predominently female (65.1%) patients was 61.88. From observing the differences in healing times at the three evaluation stages, it was clear that after the initial evaluation the wound area decreased in Groups 1 and 2 (p>0.05). CONCLUSION:The use of the customized Unna boot contributes to quicker healing. However, over a period of three months the simple bandage applications were seen to be just as effective as the Unna boot method.

Effects of the Preoperative Administration of Dexketoprofen Trometamol on Pain and Swelling After Implant Surgery: A Randomized, Double-Blind Controlled Trial

2018 ◽  
Vol 44 (2) ◽  
pp. 122-129
Author(s):  
Arturo Sánchez-Pérez ◽  
Jesús Muñoz-Peñalver ◽  
María José Moya-Villaescusa ◽  
Carmen Sánchez-Matás
Keyword(s):  
Placebo Group ◽  
Postoperative Pain ◽  
Controlled Trial ◽  
Test Group ◽  
Control Group ◽  
Double Blind ◽  
Implant Surgery ◽  
Lower Pain ◽  
Dexketoprofen Trometamol ◽  
Group A

The fear of postoperative pain is often mentioned by patients as one of the factors that is most frequently associated with dental implants. To reduce this factor, a single oral dose of 25 mg dexketoprofen trometamol (DKT) or placebo was administered 15 minutes before implant surgery. One hundred patients who required single-implant treatments were randomly assigned to 1 of 2 blinded groups. The patients in the test group were given 25 mg DKT (DKT group), and those in the control group were given 500 mg vitamin C as a placebo (PLACEBO group). A subjective visual analogue scale of 100 mm in length was used to evaluate pain. Inflammation and complications were assessed using a 5-point Likert scale. An analysis of variance, t-tests, and a Mann-Whitney U test were performed. Among the 100 patients, 83 completed the study (there were 8 dropouts in the PLACEBO group and 9 in the DKT group). The patients who received DKT reported a lower pain intensity during the immediate postoperative period. The inflammatory response was weaker in the DKT group than the control group at 48 hours, but bleeding was greater. There were no other complications in either of the groups. In conclusion, the preemptive use of 25 mg soluble DKT administered orally 15 minutes before implant surgery can reduce the severity of immediate postoperative pain.

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