scholarly journals Venous Leg Ulcers: Advanced Therapies and New Technologies

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1569
Author(s):  
Hubert Aleksandrowicz ◽  
Agnieszka Owczarczyk-Saczonek ◽  
Waldemar Placek
Keyword(s):  
New Technologies ◽  
Platelet Rich Plasma ◽  
Standard Of Care ◽  
Intermittent Pneumatic Compression ◽  
Venous Ulcer ◽  
Leg Ulcers ◽  
Plasma Therapy ◽  
Cell Therapies ◽  
Venous Leg Ulcers ◽  
Advanced Therapies

The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.

Treatment of venous leg ulcers using bilayered living cellular construct

2020 ◽  
Vol 9 (13) ◽  
pp. 907-918
Author(s):  
Aseel Bin Sawad ◽  
Fatema Turkistani
Keyword(s):  
Healthcare System ◽  
Cost Savings ◽  
Standard Of Care ◽  
Healthcare Resource Utilization ◽  
Psychological Status ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Time Period ◽  
The Us ◽  
Economic Analyses

Background: Venous leg ulcers (VLUs) present a significant economic burden on the US healthcare system and payers (US$14.9 billion). Aim: To evaluate the quality of life (QoL) of patients with VLUs; to analyze the limitations of standard of care (SOC) for VLUs; and to explain how using bilayered living cellular construct (BLCC) with SOC for treatment of VLUs can help heal more VLUs faster (than using SOC alone) as well as help improve QoL and help reduce the burden on the US healthcare system and payers. Materials & methods: This is a review study. The search was conducted in February 2020 by way of electronic databases to find relevant articles that provided information related to QoL of patients with VLUs, limitations of SOC for VLUs and economic analyses of using BLCC for treatment of VLUs. Results: VLUs impact patients’ physical, functional and psychological status and reduce QoL. A total 75% of VLU patients who used SOC alone failed to achieve healing in a timely fashion, which led to increased healthcare costs and healthcare resource utilization. Although the upfront cost is high, the greater effectiveness of BLCC offsets the added cost of the product during the time period of the studies. Therefore, BLCC helps to improve the QoL of VLU patients. As an example, for every 100 VLU patients in a healthcare plan, the use of BLCC can create cost savings of US$1,349,829.51. Conclusion: Payers’ coverage of BLCC results in reduction of the overall medical cost for treating VLU patients.

Autologous platelet-rich plasma in treatment of chronic venous leg ulcers: A prospective case series

Vascular ◽  
2014 ◽  
Vol 23 (6) ◽  
pp. 580-585 ◽  
Author(s):  
Seyhan Yilmaz ◽  
Eray Aksoy ◽  
Suat Doganci ◽  
Adnan Yalcinkaya ◽  
Adem I Diken ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Case Series ◽  
Leg Ulcers ◽  
Wound Surface ◽  
Wound Area ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Prospective Case Series ◽  
Complete Wound Healing

StudyWe report our results on a case series of 19 patients receiving platelet-rich plasma application in treatment of patients with chronic unhealing venous leg ulcers.Material and methodsThere were 16 males and three females with a mean age of 38.55 ± 16.46 years. Planimetric size measurements were performed and pain was tested throughout the treatment period. Follow-up was made in seven-day periods. Patients received 5 ml of platelet-rich plasma for each 5 cm2of the wound surface with half of the amount being injected 1–2 mm deep into the wound and the wound surface was covered with the remaining half.ResultsComplete wound healing occurred in 18 of 19 patients (94.7%) within a mean of 4.82 ± 2.16 week. There were significant reductions in wound area among all consecutive measurements except for first week. A significant reduction in wound volume was apparent even in first week and sustained among consecutive measurements.ConclusionPlatelet-rich plasma seems effective in terms of promoting healing of venous leg ulcers. Improvement in wound depth was slightly more prominent than that in wound area, indicating a potential role of platelet-rich plasma especially in deep venous ulcers.

Venous Leg Ulcer Healing: A Randomized Prospective Study of Long-Stretch versus Short-Stretch Compression Bandages

1998 ◽  
Vol 13 (2) ◽  
pp. 59-63 ◽  
Author(s):  
L. Danielsen ◽  
S. M. Madsen ◽  
L. Henriksen
Keyword(s):  
Ulcer Healing ◽  
Venous Ulcer ◽  
Positive Influence ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Venous Leg Ulcers ◽  
Area Reduction ◽  
Compression Bandages ◽  
Table Analysis

Objective: To compare the efficacy of a long-stretch bandage with that of a short-stretch compression bandage. Design: Prospective evaluation of healing of venous leg ulcers in blindly randomized groups of patients. Setting: Bispebjerg Hospital, Copenhagen, Denmark. Patients: Forty-three patients with venous leg ulcers were included. Forty legs in 40 patients were evaluated at 1 month (34 patients), 6 months (32 patients) or 12 months (27 patients). Interventions: Both types of bandage were used at a width of 10 cm and applied using the same spiral bandaging technique. Main outcome measures: Ulcer healing and ulcer area reduction. Results: Healed ulcers after 1 month were observed in 27% of the long-stretch group and in 5% of the short-stretch group ( p = 0.15); after 6 months the corresponding figures were 50% and 36% ( p = 0.49) and after 12 months 71% and 30% ( p = 0.06). Using life-table analysis the predicted healing rate in the long-stretch group after 12 months was 81% and for the short-stretch group 31% ( p = 0.03). The mean of relative ulcer areas at 1 month was 0.45 for the long-stretch group and 0.72 for the short-stretch group ( p = 0.07), at 6 months the corresponding figures were 0.81 and 0.60 ( p = 0.25) and at 12 months 0.25 and 0.95 ( p = 0.01). Conclusions: The present study appears to indicate a Positive influence of the elasticity of a compression bandage on venous ulcer healing.

scholarly journals Autologous platelet‐rich plasma for healing chronic venous leg ulcers: Clinical efficacy and potential mechanisms

2019 ◽  
Vol 16 (3) ◽  
pp. 788-792 ◽  
Author(s):  
Carolina D. Weller ◽  
Elizabeth E. Gardiner ◽  
Jane F. Arthur ◽  
Melissa Southey ◽  
Robert K. Andrews
Keyword(s):  
Clinical Efficacy ◽  
Platelet Rich Plasma ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Cost-effectiveness of using intermittent pneumatic compression to manage hard-to-heal venous leg ulcers in the UK

2021 ◽  
Vol 30 (7) ◽  
pp. 544-552
Author(s):  
Julian F Guest ◽  
Karen Staines ◽  
Nina Murphy
Keyword(s):  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Intermittent Pneumatic Compression ◽  
Quality Adjusted Life Year ◽  
Controlled Study ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Cost Effective Treatment ◽  
The Cost

Objective: To estimate whether thigh-administered intermittent pneumatic compression (IPC) could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of hard-to-heal venous leg ulcers (VLUs). Method: A Markov model was constructed depicting the management of hard-to-heal VLUs with IPC plus standard care or standard care alone over a period of 24 weeks. The model estimated the cost-effectiveness of the two interventions in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2019/20 prices. Results: Treatment of hard-to-heal VLUs with IPC plus standard care instead of standard care alone is expected to increase the probability of healing by 58% (from 0.24 to 0.38) at 24 weeks and increase health-related quality of life over 24 weeks from 0.32 to 0.34 QALYs per patient. Additionally, the cost of treating with IPC plus standard care (£3,020 per patient) instead of standard care alone (£3,037 per patient) has the potential to be cost-neutral if use of this device is stopped after 6 weeks in non-improving wounds. Sensitivity analysis showed that the relative cost-effectiveness of IPC plus standard care remains <£20,000 per QALY with plausible variations in costs and effectiveness. Conclusion: Within the limitations of this study, the addition of IPC to standard care potentially affords a cost-effective treatment to the NHS for managing hard-to-heal VLUs. However, a controlled study is required to validate the outcomes of this analysis.

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