scholarly journals A novel concept of pneumatic pump in the outpatient management of mixed leg ulceration: a pilot study

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Mirko Tessari ◽  
Sergio Gianesini ◽  
Paolo Spath ◽  
Erica Menegatti ◽  
Maria Grazia Sibilla ◽  
...  
Keyword(s):  
Analogue Scale ◽  
Femoral Vein ◽  
Vascular Diseases ◽  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Novel Device ◽  
Compression Bandaging ◽  
Novel Concept ◽  
Pneumatic Pump ◽  
Ulcer Treatment

Mixed leg ulcer is a challenge in vascular diseases because both arterial and venous systems of the lower extremities are involved in the wound pathogenesis. Management is very difficult because the coexistence of the two conditions sometimes prevent to use compression bandaging, which is the cornerstone of venous leg ulcer treatment. It has been recently developed the so called gradient pump (GP), a novel device which permits to intermittently stop the flow in the femoral vein with a pneumatic cuff placed on the thigh. Subsequent release of the femoral vein compression determines a dramatic aspiration of the blood up-ward the heart, with synchronous and measured improved perfusion of the distal limb. We applied GP at 4 consecutive cases of multiple mixed painful ulcerations of the foot and leg scheduled for below knee and/or foot amputations. In all cases measure of pain by visual analogue scale significantly decreased; GP in most cases together intravenous infusion of synthetic prostacyclin led to improvement and/or minimal amputation. Therefore such a management can be done on outpatient bases, allowing a considerable lowering of health costs. We conclude that GP could be a valuable tool in the arsenal of mixed leg ulcer clinical assessment.

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.

Venous leg ulcer treatment and practice — part 2: wound management

2007 ◽  
Vol 16 (2) ◽  
pp. 68-70 ◽  
Author(s):  
S. Rajendran ◽  
A.J. Rigby ◽  
S.C. Anand
Keyword(s):  
Leg Ulcer ◽  
Wound Management ◽  
Venous Leg Ulcer ◽  
Ulcer Treatment

Ankle Motility is a Risk Factor for Healing of Chronic Venous Leg Ulcers

2001 ◽  
Vol 16 (1) ◽  
pp. 38-40 ◽  
Author(s):  
J. R. Barwell ◽  
M. Taylor ◽  
J. Deacon ◽  
C. Davies ◽  
M. R. Whyman ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pump Power ◽  
Ulcer Healing ◽  
Independent Risk Factor ◽  
Healing Rate ◽  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Compression Bandaging ◽  
Venous Ulcers ◽  
Ulcer Healing Rate

Objective: To investigate the effect of ankle motility on chronic venous leg ulcer healing, and to relate this to calf pump function and muscle bulk. Methods: This was a prospective cohort study undertaken in a leg ulcer clinic. Ankle motility, calf-ankle circumference ratio and calf pump power (derived from digital photoplethysmography) were assessed as to their effect on ulcer healing rate. Thirty consecutive patients undergoing multi-layer compression bandaging for open chronic venous ulcers were included. Results: Ankle motility was an independent risk factor for ulcer healing ( p = 0.001, hazard ratio 1.08, 95% CI 1.03–1.13). Ankle motility correlated with calf-ankle circumference ratio ( r = 0.48, p<0.01). No relationship was found between photoplethysmography-derived calf pump power, ankle motility or ulcer healing rate. Conclusions Ulcers in legs with poor ankle motility are slower to heal and this may be related to reduced calf muscle bulk. Ankle exercises or physiotherapy could be considered in such patients.

scholarly journals Reply-letter to editor: From compression to injections: prostaglandins paving a new direction for venous leg ulcer treatment

2019 ◽  
Vol 6 (4) ◽  
pp. 331
Author(s):  
RajendraPrasad Basavanthappa ◽  
AshwiniNaveen Gangadharan ◽  
SanjayC Desai ◽  
AR Chandrashekar
Keyword(s):  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Ulcer Treatment

Evaluation of the efficiency of venous leg ulcer treatment with a membrane dressing

2004 ◽  
Vol 26 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Andrzej Ślęzak ◽  
Marek Kucharzewski ◽  
Andrzej Franek ◽  
Wojciech Twardokęs
Keyword(s):  
Leg Ulcer ◽  
Venous Leg Ulcer ◽  
Ulcer Treatment

scholarly journals Patient Explanation of Adherence and Non-Adherence to Venous Leg Ulcer Treatment: A Qualitative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Carolina D. Weller ◽  
Catelyn Richards ◽  
Louise Turnour ◽  
Victoria Team
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Treatment Adherence ◽  
Theoretical Domains Framework ◽  
Environmental Context ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Venous Leg Ulcers ◽  
Ulcer Treatment

The aim of this study was to understand which factors influence patients’ adherence to venous leg ulcer treatment recommendations in primary care. We adopted a qualitative study design, conducting phone interviews with 31 people with venous leg ulcers in Melbourne, Australia. We conducted 31 semi-structured phone interviews between October and December 2019 with patients with clinically diagnosed venous leg ulcers. Participants recruited to the Aspirin in Venous Leg Ulcer Randomized Control Trial and Cohort study were invited to participate in a qualitative study, which was nested under this trial. We applied the Theoretical Domains Framework to guide the data analysis. The following factors influenced patients’ adherence to venous leg ulcer treatment: understanding the management plan and rationale behind treatment (Knowledge Domain); compression-related body image issues (Social Influences); understanding consequences of not wearing compression (Beliefs about Consequences); feeling overwhelmed because it’s not getting better (Emotions); hot weather and discomfort when wearing compression (Environmental Context and Resources); cost of compression (Environmental Context and Resources); ability to wear compression (Beliefs about Capabilities); patience and persistence (Behavioral Regulation); and remembering self-care instructions (Memory, Attention and Decision Making). The Theoretical Domains Framework was useful for identifying factors that influence patients’ adherence to treatment recommendations for venous leg ulcers management. These factors may inform development of novel interventions to optimize shared decision making and self-care to improve healing outcomes. The findings from this article will be relevant to clinicians involved in management of patients with venous leg ulcers, as their support is crucial to patients’ treatment adherence. Consultation with patients about VLU treatment adherence is an opportunity for clinical practice to be targeted and collaborative. This process may inform guideline development.

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