scholarly journals Healing Rates of Venous Leg Ulcer Using Four Layer Bandage and Short Stretch Bandage- A Comparative Study in Aspect of Bangladesh

2020 ◽  
Vol 16 (2) ◽  
pp. 78-85
Author(s):  
Rakibul Hasan ◽  
Md Saif Ullah Khan ◽  
Mainul Mahmud ◽  
Samaresh Chandra Saha ◽  
Sourav Bhowmick
Keyword(s):  
Primary Outcome ◽  
Single Layer ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Secondary Outcome ◽  
P Value ◽  
Venous Disease ◽  
Venous Leg Ulcer ◽  
Time Duration

Background: Chronic venous leg ulcer is one of the common medical conditions encounter by the vascular surgeons in Bangladesh. Many of these patients develop venous leg ulcer as a sequel of the disease. In advance chronic venous disease such as development of ulcer, single or multilayer dressings are usually used. Objective: To find out a compression therapy (single layer crepe/short stretch bandage and multilayer/four layer bandage) in patients with venous leg ulcer. Materiel & Methods: This study was conducted on 200 patients with in last two years, march 2017 to february 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of vascular surgery. In which 100 patients with venous leg ulcer where treated with four layer bandage and another 100 patients with same condition were treated with single layer crepe bandage. Before application of bandage, proper history of patient was taken and duplex scan was done. The primary outcome was measured by time duration of ulcer healing. Secondary outcome included incidence and number of adverse events in every patient. Results: Healing time of venous ulcers was accessed with periodic interval. The four layer bandage was associated with significantly shorter time of healing. P value reached from unpaired t-test. Primary outcome shows 68% of patients who received four layer bandages achieved healing within one month. On the other hand, 12% of patients who received single layer/crepe bandage did so. Conclusion: Four layer bandages heals venous leg ulcer more rapidly than the single layer crape bandage. These data suggest that the benefits observed the consistent despite prognosis is different. Patients with large ulcers have poor healing prognosis regardless of its treatment modalities. University Heart Journal Vol. 16, No. 2, Jul 2020; 78-85

scholarly journals A qualitative study on the patient's narrative in the progression of chronic venous disease into a first venous leg ulcer: a series of events

2019 ◽  
Vol 183 (2) ◽  
pp. 332-339 ◽  
Author(s):  
A.M. Meulendijks ◽  
M. Welbie ◽  
E.P.M. Tjin ◽  
L. Schoonhoven ◽  
H.A.M. Neumann
Keyword(s):  
Qualitative Study ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Leg Ulcer

A scoping review on Chronic Venous Disease and the development of a Venous Leg Ulcer: The role of obesity and mobility

2020 ◽  
Vol 29 (3) ◽  
pp. 190-196
Author(s):  
A.M. Meulendijks ◽  
W.M.A. Franssen ◽  
L. Schoonhoven ◽  
H.A.M. Neumann
Keyword(s):  
Scoping Review ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Leg Ulcer

A COMPARATIVE STUDY BETWEEN THE EFFECTIVENESS OF AUTOLOGOUS PLATELET-RICH FIBRIN VERSUS SALINE DRESSING IN THE MANAGEMENT OF CHRONIC VENOUS LEG ULCERS

2021 ◽  
pp. 45-47
Author(s):  
Prateek Shakya ◽  
Akash Singh ◽  
K.S. Shahi
Keyword(s):  
Leg Ulcer ◽  
Treatment Modalities ◽  
Venous Stasis ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Ulcer Size ◽  
Ulcer Area ◽  
Venous Leg Ulcers ◽  
The Mean

Background: Venous disease is responsible for around 85% of all chronic lower limb ulcers in resource-rich countries. Venous leg ulcer is a chronic condition, and various treatment modalities are available. Various adjunctive wound care therapies and procedures are available that can be utilized as part of a comprehensive approach to healing venous stasis ulcers. Platelet-rich brin (PRF) is one of the newer modalities and it contains broblast growth factor (FGF), VEGF, angiopoietin and platelet-derived GF which enhances the wound healing. We conducted a randomized controlled trial to compare the efcacy of PRF versus saline dressing in chronic venous leg ulcers. Aim: To compare the efcacy of autologous PRF with saline dressing in patients with chronic venous leg ulcer in terms of mean reduction in ulcer area, presence of infection and cosmetic outcome at the end of 4 weeks. Materials and Methods: Thirty patients with chronic venous leg ulcers of >6 months duration having an ulcer area of 1 cm × 1 cm to 5 cm × 5 cm were taken into the study and were randomly divided into two groups. Group 1: Patients received PRF dressing. 10 mL of patient's blood was taken and centrifuged at 3000 rpm for 15 min. A brin clot obtained in the middle of the tube was removed and used for dressing over the wound surface. It was repeated every week for 4 weeks. Group 2: Patients received saline dressings once a week for 4 weeks. The assessment of the ulcer size was done with the help of photographs, and ulcer area was measured. Results: The mean reduction in the area of the ulcer size in PRF group was 81.84%, and the mean reduction in the area of the ulcer size in Saline group was 59.84%. Conclusion: Platelet rich brin matrix is a novel modality and an ideal, safe, affordable therapeutic option for chronic venous leg ulcers.

Lothian and Forth Valley Leg Ulcer Healing Trial, Part 1: Elastic versus Non-Elastic Bandaging in the Treatment of Chronic Leg Ulceration

1992 ◽  
Vol 7 (4) ◽  
pp. 136-141 ◽  
Author(s):  
M. J. Callam ◽  
D. R. Harper ◽  
J. J. Dale ◽  
D. Brown ◽  
B. Gibson ◽  
...  
Keyword(s):  
Ulcer Healing ◽  
Interaction Analysis ◽  
Leg Ulcer ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Duration Of Treatment ◽  
Venous Leg Ulcer ◽  
Venous Ulcers ◽  
Independent Evaluation ◽  
Application Techniques

Objective: To determine whether elastic or non-elastic bandaging is more effective in healing chronic venous ulcers. Design: Randomized trial with factorial design and interaction analysis, enabling independent evaluation of both bandaging and dressings within the single-trial format. The duration of treatment was 12 weeks or until ulcer-healing, whichever occurred sooner. Setting: The Leg Ulcer Clinics of Edinburgh and Falkirk and District Royal Infirmaries, Scotland. Patients: 132 patients with chronic leg ulcers and clinical evidence of chronic venous disease, and excluding those with Doppler ultrasound ankle/brachial pressure indices of less than 0.8, diabetes or rheumatoid disease. There were 28 withdrawals who were classified for analysis as treatment failures. Interventions: Elastic or non-elastic multilayer bandage systems were applied using similar application techniques by a team of trained nurse specialists. All other treatments were standardized, including the randomization of dressings to either a knitted viscose or a hydrocellular polyurethane dressing. Main outcome measure: Complete ulcer healing. Results: In the elastic group 35 out of 65 ulcers (54%) healed within 12 weeks compared with 19 out of 67 (28%) in the non-elastic group (95% confidence limits for percentage healed, 9% to 42%). Ulcer pain was also reported significantly less often in the elastic group (48% of visits versus 29%; p=0.03). Conclusion: When applied by similar multilayer bandaging techniques, elastic bandaging was significantly better than non-elastic bandaging in the treatment of chronic venous leg ulcer.

Venous leg ulcer in the context of chronic venous disease

2013 ◽  
Vol 29 (4) ◽  
pp. 220-226 ◽  
Author(s):  
F S Lozano Sánchez ◽  
J Marinel Io Roura ◽  
E Carrasco Carrasco ◽  
J R González-Porras ◽  
J R Escudero Rodríguez ◽  
...  
Keyword(s):  
Short Form ◽  
Cross Sectional Study ◽  
Leg Ulcer ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Control Group ◽  
Venous Disease ◽  
Venous Leg Ulcer ◽  
Cross Sectional ◽  
Venous Clinical Severity Score

Objectives Chronic venous disease (CVD) is a frequent disorder with a high socioeconomic impact. Little is known about the possible differences between healed ulcer (C5 group) and active ulcer (C6 group) in terms of disease severity and quality of life (QoL). Our aim was to determine the possible differences in severity disease and QoL between the C5–C6 and C1 (control) group. Methods Data from a national, multicentre, observational and cross-sectional study ( n = 1598) were used to compare three groups of CVD: C1 ( n = 243), C5 ( n = 136) and C6 ( n = 70). CVD severity was assessed with the Venous Clinical Severity Score (VCSS) and QoL with the Short Form 12 Health Survey (SF-12) and Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ-20). Results Patients with active ulcers had a higher mean total VCSS than patients with healed ulcers ( P < 0.05). Both SF-12 and CIVIQ-20 QoL questionnaires indicated a poorer QoL in patients with ulcers than in those with C1 ( P < 0.05). Compared with the C5 group, patients with active ulcers (C6) had lower QoL scores, but the differences were not statistically significant. Conclusions Patients with venous leg ulcers (C5–C6) are associated with high severity and poor QoL. However, the healing of a leg ulcer did not contribute to improvement of QoL.

CHIVA, ASVAL and related techniques – Concepts and evidence

2015 ◽  
Vol 30 (2_suppl) ◽  
pp. 42-45 ◽  
Author(s):  
Sarah Onida ◽  
Alun H Davies
Keyword(s):  
Minimally Invasive ◽  
Varicose Veins ◽  
Disease Process ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Venous Disease ◽  
Invasive Treatment ◽  
Venous Circulation ◽  
Underlying Pathophysiology

Chronic venous disease (CVD) is a highly prevalent condition with significant effects on patients’ quality of life. Despite this, the underlying pathophysiology of venous disease still remains unclear. Two schools of thought exist, explaining the development and propagation of venous disease as an “ascending” and “descending” process, respectively. The descending theory, stating that CVD is secondary to proximal disease (e.g. saphenofemoral/saphenous incompetence), is the most widely accepted when planning treatment aiming to remove or destroy the junction or truncal veins. The ascending theory, describing the disease process as developing in the lower most part of the leg and propagating cranially, aims to re-route the venous circulation via minimally invasive interventions. Classically, superficial venous insufficiency has been treated with the removal of the incompetent trunk, via open surgery or, increasingly, with endovenous interventions. Minimally invasive treatment modalities aiming to preserve the saphenous trunk, such as CHIVA and ASVAL, may also play an important role in the treatment of the patient with varicose veins.

scholarly journals CHRONIC VENOUS INSUFFICIENCY

10.23856/3217 ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 131-136
Author(s):  
Antoni Stadnicki ◽  
Martin Rusnák ◽  
Anna Stadnicka
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Chronic Venous Disease ◽  
Postthrombotic Syndrome ◽  
Venous Disease ◽  
Compression Stockings ◽  
Venous Leg Ulcer ◽  
Color Flow ◽  
Clinical Disorder

Chronic venous insufficiency (CVI) is a common, but underdiagnozed clinical disorder associated with a variety of signs and symptoms. The presence of leg edema in association  with varicose veins, and venous leg ulcer in later disease stages defines the disease. The pathogenesis of chronic venous disease  is based on venous reflux, obstruction, or a combination thereof.  Prior postthrombotic syndrome   is one of risk factor for CVI which may explain observed  prevalence of thrombophilia in CVI. Color flow duplex ultrasound is the gold standard for nearly all diagnostic issues related to chronic venous disease. Compression stockings are the mainstay for conservative management. Earlier use of venous ablation therapy should be considered in symptomatic patients with superficial tortuous vein

scholarly journals A multi-centre, prospective, randomised controlled feasibility study of plantar resistance exercise therapy for venous leg ulcers – Results of the PREVUE study

2019 ◽  
Vol 35 (4) ◽  
pp. 237-246
Author(s):  
Leon Jonker ◽  
Jane Todhunter ◽  
Jose Schutter ◽  
Charlotte Halliday ◽  
Stacey Fisher
Keyword(s):  
Resistance Exercise ◽  
Exercise Programme ◽  
Complete Healing ◽  
Leg Ulcer ◽  
P Value ◽  
Daily Routine ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Potential Health ◽  
Venous Leg Ulcers

Objectives To evaluate the feasibility of an interventional study involving a seated plantar resistance exercise programme, using a StepIt pedal, aimed at promotion of venous leg ulcer healing. Methods Thirty-two venous leg ulcer patients, recruited from community, GP and hospital settings, were randomised to either a standard care or adjuvant StepIt exercise programme arm for up to 12 weeks. The exercise involved a twice daily routine of 10 times 1 min of exercise, i.e. 2 s push and 2 s lift repetitions (equating to 300 daily ‘steps’). Results Complete healing of the venous leg ulcers was observed in 10 out of 15 (67%; StepIt cohort) and 7 out of 17 (41%; control cohort), respectively (p-value 0.18, Fisher’s exact test). Baseline differences between the two cohorts were longer wound chronicity, less venous leg ulcer-related pain and better venous leg ulcer-related quality of life in the StepIt cohort. One adverse event, involving increased wound exudate and slough production, was observed in a participant using StepIt, and no study withdrawals were recorded in either arm. StepIt users whose wound had completely healed by week 12 were more likely to be compliant with the exercise programme (self-reported) and more positive about the trial experience; however, all would recommend the device to others. Conclusions Seated plantar resistance exercise shows promise and may accelerate venous leg ulcer wound healing. The StepIt pedal is well-received by patients, and its efficacy may depend on the degree of patient compliance with the exercise programme. Further larger scale studies are indicated to allow more concrete inferences to be made on the clinical and potential health economics impact that this device may have.

Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up

2015 ◽  
Vol 25 (6) ◽  
pp. 1527-1536 ◽  
Author(s):  
Kadir Çeviker ◽  
Şahin Şahinalp ◽  
Erdinç Çiçek ◽  
Deniz Demir ◽  
Dinçer Uysal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Venous Disease

Abstract 12936: Impact of Mitral Regurgitation on Heart Failure Hospitalization and Mortality in Older Age Adults With a Preserved Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ginger Y Jiang ◽  
Warren J Manning ◽  
Lawrence Markson ◽  
A. R Garan ◽  
Marwa A Sabe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
P Value ◽  
Preserved Ejection Fraction ◽  
Risk Of Death ◽  
Increased Risk ◽  
All Cause Mortality

Background: The effect of mitral regurgitation (MR) severity on heart failure (HF) hospitalization and mortality in individuals with a preserved ejection fraction (LVEF) and no prior HF history is uncertain. Methods: Transthoracic echocardiogram (TTE) reports from patients with an LVEF > 50% at our institution were linked to complete Medicare inpatient claims, 2003-2017. Patients with HF hospitalization within the 12 months prior to TTE were excluded. We evaluated the relationship of baseline MR severity and time to the composite of all-cause mortality or HF hospitalization using the Kaplan-Meier technique. Secondary outcomes included the individual components of all-cause mortality and HF hospitalization, adjusting for the competing risk of death with Fine-Gray methods. Results: A total of 18,315 individuals met inclusion criteria (77.6 ±7.7 years, 54.3% female). Over a median follow-up time of 6.5 (IQR 3.0 to 10.2) years, the primary endpoint occurred in 7566 individuals (50.6%) of whom 6,927 (37.8%) died and 1703 (13.9%) were admitted for HF at a median of 1.4 (IQR 0.2 to 4.3) years and 1.6 (IQR 0.2 to 4.3) years respectively ( Figure ). After multivariable adjustment, MR severity was not associated with the primary or secondary outcome at 1-, 3-, 5-, or 10-years after TTE (p > 0.05 for all). Mitral valve prolapse (MVP) was associated with decreased risk of the primary outcome at 1-year and 3-years (interaction p-value = 0.04 for both). Jet eccentricity did not impact the observed relationship (interaction p-value > 0.05). Conclusions: In this large, single institution echocardiographic study of individuals with preserved ejection fraction and no prior history of HF, MR severity was not associated with an increased risk of all-cause mortality or HF hospitalization. Presence of MVP was associated with decreased risk of the primary outcome with increasing MR severity.

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