scholarly journals Chronic venous insufficiency and interest of adjustable compression wrap devices

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
Knut Kroeger ◽  
Joachim Dissemond
Keyword(s):  
Venous Insufficiency ◽  
Compression Therapy ◽  
Pressure Control ◽  
Lower Leg ◽  
Self Management ◽  
Compression Pressure ◽  
Pressure System ◽  
Individual Bands ◽  
Technical Features ◽  
The Individual

Adjustable compression wrap devices (ACWD) are a heterogenic group which makes it difficult to match them to individual patient in their best way, we tried to characterize these products by their technical features. We bought four different ACWD and compared them regarding construction and handling. ACWD show obvious advantages including self-management, self-application, re-adjustability and standardization of the compression therapy. Basically, all systems are one or more low stretch bandages that encircle the lower leg and adhere to itself with velcro. Some allow for a selective adjustment during the course of the application because in these systems the individual bands mutually intermesh. In others, the bandages must always be opened from proximal to distal in order to retighten individual segments. In addition only one enables the user to control the compression pressure of each segment by a built-in-pressure system. Different technical features of the four ACWDs make it difficult to compare them. For effective compression easy handling, selective adjustments and a reliable pressure control seem to be the most important aspects.

scholarly journals Effect of Postoperative Compression Therapy on the Success of Liposuction in Patients with Advanced Lower Limb Lymphedema

2021 ◽  
Vol 10 (21) ◽  
pp. 4852
Author(s):  
Shuhei Yoshida ◽  
Isao Koshima ◽  
Hirofumi Imai ◽  
Solji Roh ◽  
Toshiro Mese ◽  
...  
Keyword(s):  
High Pressure ◽  
Lower Limb ◽  
Compression Therapy ◽  
Lower Leg ◽  
Limited Information ◽  
Compression Method ◽  
Compression Pressure ◽  
Improvement Rate ◽  
Significant Difference ◽  
Successful Group

Objective: There is limited information on postoperative care after liposuction for lymphedema limb. The aim of this retrospective study was to identify the threshold compression pressure and other factors that lead liposuction for lower limb lymphedema to success. Materials and Methods: Patients were divided according to whether they underwent compression therapy with both stockings and bandaging (SB group), stockings alone (S group), or bandaging alone (B group) for 6 months after liposuction. The postoperative compression pressure and rate of improvement were compared according to the postoperative compression method. We also investigated whether it was possible to decrease the compression pressure after 6 months. Liposuction was considered successful if improvement rate was >15. Results: Mean compression pressure was significantly lower in the S group than in the SB group or B group. The liposuction success rate was significantly higher in the SB group than in the B group or S group. There was not a significant difference between the values at 6 months after liposuction and at 6 months after a decrease in compression pressure in the successful group. Conclusion: Our results suggest that stable high-pressure postoperative compression therapy is key to the success of liposuction for lower limb lymphedema and is best achieved by using both stockings and bandages. The postoperative compression pressure required for liposuction to be successful was >40 mmHg on the lower leg and >20 mmHg on the thigh. These pressures could be decreased after 6 months.

scholarly journals Self-management by firm, non-elastic adjustable compression wrap device [Translation of Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung]

2017 ◽  
Vol 6 (3) ◽  
Author(s):  
Giovanni Mosti ◽  
Hugo Partsch
Keyword(s):  
Venous Insufficiency ◽  
Arterial Occlusive Disease ◽  
Self Management ◽  
Target Range ◽  
Subjective Feeling ◽  
Compression Stockings ◽  
Compression Pressure ◽  
Compression Device ◽  
Strong Compression ◽  
Measured Pressure

<p>Severe forms of chronic venous insufficiency and lymphedema require strong compression-pressure, which exceeds the pressure exerted by medical compression stockings (&gt;40 mmHg). The aim was to investigate if patients are able to apply a Velcro-band compression device (Circaid Juxta Lite™) themselves with sufficient pressure. Thirty-one patients (CEAP C6=23, C5=5, C3=2, mixed ulcer=1) applied Juxta Lite™ on their own legs after a short instruction and were asked to readjust the pressure by their subjective feeling. Sub- bandage pressure was measured after application and 24 h later. In 30 patients without arterial occlusive disease the median sub- bandage pressure values on day 1 and day 2 were 44,5 mmHg (IQR 42-48), and 46 mmHg (IQR 44-48,25) respectively. One patient with an arterialvenous leg ulcer showed pressures of 34 and 36 mmHg. All measured pressure values corresponded to the pursued target range, demonstrating that adequate self application of Velcro bands is feasible and that patents can maintain this pressure by re-adjustment.</p><p><em>Source: this paper is an abridged translation of Mosti G, Partsch H. Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung. Vasomed 2017;5:212-6.</em></p>

Compression in mixed ulcers: venous side

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 13-17 ◽  
Author(s):  
Giovanni Mosti
Keyword(s):  
Compression Therapy ◽  
Lower Leg ◽  
Venous Reflux ◽  
Elastic Materials ◽  
Normal Range ◽  
Compression Pressure ◽  
Reduced Pressure ◽  
Venous Ulcers ◽  
Arterial Involvement ◽  
Arterial Inflow

Introduction: arterial involvement may coexist in about 15–30 of venous ulcers. In this case compression therapy maybe applied, only by expert caregivers, with a reduced pressure which must not overcome the arterial pressure at ankle and foot level. It remains to assess if such a reduced pressure may be effective also on the impaired venous hemodynamics. Aim of this paper is to present an overview of the data we have, showing the effects on venous hemodynamics of a reduced compression pressure. Material and methods: in different groups of patients affected by deep and superficial venous incompetence, venous reflux and ejection fraction (EF) from the lower leg were measured in baseline conditions, without any compression, and after application of different elastic and inelastic compression devices exerting different pressure ranges from 20 to 60 mm Hg. The compression pressure was always recorded simultaneously with venous reflux of EF assessment. Results: strong pressures show the greatest effect in reducing/abolishing venous reflux and increasing EF but also a reduced pressure in the range of 20 to 40 mm Hg is effective in improving venous hemodynamics provided inelastic materials are used. Conclusions: inelastic but not elastic materials exert a standing pressure which is significantly higher than in supine position even starting from a reduced supine pressure of 40 mm Hg which does not impair the arterial inflow. This strong pressure is able to reduce and even abolish the venous reflux and improve the EF up to restoring its normal range. A reduced or modified compression pressure is able to significantly improve the venous hemodynamics without affecting the arterial inflow in patients with mixed ulcers, provided inelastic materials are used.

Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview (Preprint)

2018 ◽  
Author(s):  
Sylvie Naar ◽  
Jeffrey T Parsons ◽  
Bonita F Stanton
Keyword(s):  
Implementation Science ◽  
Large Body ◽  
Hiv Infections ◽  
Self Management ◽  
Management Interventions ◽  
Hiv Research ◽  
The Individual ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

BACKGROUND The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been created that decrease the rate of new HIV infections among youth and reduce morbidity among youth living with HIV. However, full benefits that should be possible based on the tools and interventions currently available are yet to be realized in youth, in large part, because efficacious interventions have not been implemented in real-world settings. Scale It Up (SIU) primarily aims to assemble research teams that will ultimately bring to practice evidence-based interventions that positively impact the youth HIV prevention and care cascades, and in turn, advance the fields of implementation science and self-management science. OBJECTIVE This paper aims to describe the structure of the U19-SIU and the effectiveness-implementation hybrid trials, as well as other center-wide protocols and initiatives, implemented within SIU. METHODS SIU will achieve its aims through 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives. RESULTS SIU was funded by National Institute for Child Health and Human Development (U19HD089875) and began in October 2016. As of November 2018, 6 SIU protocols have launched at least the first phase of work (ATN 144 SMART: Sequential Multiple Assignment Randomized Trial; ATN 145 YMHP: Young Men’s Health Project; ATN 146 TMI: Tailored Motivational Interviewing Intervention; ATN 153 EPIS: Exploration, Preparation, Implementation, Sustainment model; ATN 154 CM: Cascade Monitoring; ATN 156 We Test: Couples' Communication and HIV Testing). Further details can be found in the individual protocol papers. CONCLUSIONS To date, the youth HIV research portfolio has not adequately advanced the important care area of self-management. SIU protocols and initiatives address this broad issue by focusing on evaluating the effectiveness and implementation of self-management interventions. SIU is highly innovative for 5 primary reasons: (1) our research framework expands the application of “self-management”; (2) the 4 primary protocols utilize innovative hybrid designs; (3) our Analytic Core will conduct cost-effectiveness analyses of each intervention; (4) across all 4 primary protocols, our Implementation Science Core will apply implementation scales designed to assess inner and outer context factors; and (5) we shall advance understanding of the dynamics between provider and patient through analysis of recorded interactions. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11204

scholarly journals Time, the deer, is in the wood: Chronotopic identities, trajectories of texts and community self-management

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tom Bartlett
Keyword(s):  
Los Angeles ◽  
Text Analysis ◽  
Daily Life ◽  
Social Systems ◽  
Local Communities ◽  
Self Management ◽  
Policy Makers ◽  
Public Issues ◽  
Relevant Context ◽  
The Individual

AbstractThis paper opens with a problematisation of the notion of real-time in discourse analysis – dissected, as it is, as if time unfolded in a linear and regular procession at the speed of speech. To illustrate this point, the author combines Hasan’s concept of “relevant context” with Bakhtin’s notion of the chronotope to provide an analysis of Sorley MacLean’s poem Hallaig, with its deep-rootedness in space and its dissolution of time. The remainder of the paper is dedicated to following the poem’s metamorphoses and trajectory as it intertwines with Bartlett’s own life and family history, creating a layered simultaneity of meanings orienting to multiple semio-historic centres. In this way the author (pers. comm.) “sets out to illustrate in theory, text analysis and (self-)history the trajectories taken by texts as they cross through time and space; their interconnectedness with social systems at different scales; and the manner in which they are revoiced in order to enhance their legitimacy before the diverse audiences they encounter on their migratory paths.” In this process, Bartlett relates his own story to the socioeconomic concerns of the Hebridean island where his father was raised, and to dialogues between local communities and national and external policy-makers – so echoing Denzin’s call (2014. Interpretive Autoethnography (2nd Edition). Los Angeles: Sage: vii) to “develop a methodology that allows us examine how the private troubles of individuals are connected to public issues and to public responses to these troubles”. Bartlett presents his data through a range of legitimation strategies and voicing techniques, creating transgressive texts that question received notions of identity, authorship, legitimacy and authenticity in academia, the portals of power, and the routines of daily life. The current Abstract is one such example. As with the author’s closing caveat on the potential dangers of self-revelation, offered, no doubt, as a flimsy justification for the extensive focus in the paper on his own life as a chronotope, I leave it for the individual reader to decide if Bartlett’s approach is ultimately ludic or simply ludicrous.

scholarly journals Compression Therapy Is Not Contraindicated in Diabetic Patients with Venous or Mixed Leg Ulcer

2020 ◽  
Vol 9 (11) ◽  
pp. 3709
Author(s):  
Giovanni Mosti ◽  
Attilio Cavezzi ◽  
Luca Bastiani ◽  
Hugo Partsch
Keyword(s):  
Treatment Protocol ◽  
Compression Therapy ◽  
Healing Time ◽  
Leg Ulcer ◽  
Venous Disease ◽  
Diabetic Patients ◽  
Leg Ulcers ◽  
Foam Sclerotherapy ◽  
Compression Pressure ◽  
A Minor

The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5–0.8) occurs as in mixed leg ulcers (MLU). Materials and methods: in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure <40 mm Hg in patients with MLU and >60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU. Results: Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP (p = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP (p = −0.19). Conclusions: when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.

The pain self-management paradox: why do we focus on the individual when life context plays such a major role?

2021 ◽  
Author(s):  
Karen Rodham
Keyword(s):  
Pain Management ◽  
Health System ◽  
The Self ◽  
Self Management ◽  
Life Context ◽  
The Individual

Although there has been a drive toward pain self-management, self-management has not yet in my opinion been successfully defined or evaluated and neither has it been consistently translated from idea to practice. In this perspective article, I identify gaps in our approach to pain management and argue that even though we know life context plays a huge role in influencing our health, by and large we fail to take this into account. I argue for a shift in focus away from the ‘self’ and explore how we might be able to do this within the constraints of our tired and over-stretched health system.

scholarly journals Skin Oxygen Tension in Venous Insufficiency of the Lower Leg

1985 ◽  
Vol 78 (5) ◽  
pp. 373-376 ◽  
Author(s):  
H J Dodd ◽  
P M Gaylarde ◽  
I Sarkany
Keyword(s):  
Oxygen Tension ◽  
Venous Insufficiency ◽  
Lower Leg

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

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