scholarly journals CONCEPT OF SHADKRIYAKAALA OF VRANA BY SUSRUTHA W.S.R TO VENOUS ULCER

2020 ◽  
pp. 38-46
Author(s):  
V.B. Binya ◽  
M.M.Abdul Shukkoor ◽  
N.H.Subi
Keyword(s):  
Venous Insufficiency ◽  
Venous Ulcer ◽  
Chronic Ulcer ◽  
Purulent Discharge ◽  
Venous Obstruction ◽  
Chronic Stage ◽  
Venous Valves ◽  
Venous Ulcers ◽  
Specific Term ◽  
Arterial Ulcer

Acharya Susrutha has described about the Samprapthi (pathogenesis) of Vrana (ulcer) in detail in Susrutha samhitha sutrasthana. All the ulcers like arterial ulcer, venous ulcer, trophic ulcer etc can be considered as Vrana. But no specific term has been made by Acharya for venous ulcer. Venous ulcers are the wounds occurring as a result of inappropriate functioning of venous valves or of venous obstruction by thrombus. While going through the characteristics of Dushtavrana (chronic ulcer) like Krishna/ Suklavarna (hyper/hypopigmented areas), Deerghakaala anubandhitwa (chronicity), Durgandhitha pooyasraava (foul smelling serous/ purulent discharge) etc, venous ulcer can be considered as a dushtavrana, particularly in its chronic stage. Sira (vein) is the deranged anatomical component in case of venous insufficiency as well as venous ulcer and this Sira has been told as one of the Vranasthaanaas (sites of Vrana) by Susrutha. Hence the term Sirajadushtavrana can be attributed to venous ulcer. Aetiopathogenesis of venous ulcer has striking similarities with that of Dushtavrana. In this article, a gentle attempt has been made to correlate the aetiopathogenesis of venous ulcer with the specific characteristics said in each stage of Shadkriyakala (aetiopathogenesis) of Vranasamprapthi (ulcer) as told by Acharya.

The Beneficial Augmentative Effect of Micronised Purified Flavonoid Fraction (MPFF) on the Healing of Leg Ulcers: An Open, Multicentre, Controlled, Randomised Study

1999 ◽  
Vol 14 (4) ◽  
pp. 151-157 ◽  
Author(s):  
W. Gliński ◽  
B. Chodynicka ◽  
J. Roszkiewicz ◽  
T. Bogdanowski ◽  
B. Lecewicz-Toruń ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Ulcer ◽  
Control Group ◽  
Cure Rate ◽  
Randomised Study ◽  
Venous Ulcers ◽  
The Mean ◽  
Flavonoid Fraction ◽  
The Cost

Objective: To determine the increase in healing rate of venous ulcer in patients receiving a micronised purified flavonoid fraction (MPFF) as supplementation to standard local care. Design: A randomised, open, controlled, multicentre study. Setting: Departments of Dermatology and University Outpatients Clinics. Patients: One hundred and forty patients with chronic venous insufficiency and venous ulcers. Intervention: Patients received standard compressive therapy plus external treatment alone or 2 tablets of MPFF daily in addition to the above treatment for 24 weeks. Main outcome measure: Healing of ulcers and their reduction in size after 24 weeks of treatment. Results: The percentage of patients whose ulcers healed completely was found to be markedly higher in those receiving MPFF in addition to standard external and compressive treatment than in those treated with conventional therapy alone (46.5% vs 27.5%; p<0.05, OR = 2.3, 95% CI 1.1–4.6). Ulcers with diameters <3 cm were cured in 71% of patients in the MPFF group and in 50% of patients in the control group, whereas ulcers between 3 and 6 cm in diameter were cured in 60% and 32% of patients ( p<0.05), respectively. The mean reduction in ulcer size was also found to be greater in patients treated with MPFF (80%) than in the control group (65%) ( p<0.05). The cost-effectiveness ratio (cost per healed ulcer) in the MPFF group was €1026.2 compared with €1871.8 in the control group. Conclusions: These results indicate that MPFF significantly improves the cure rate in patients with chronic venous insufficiency.

Seasonal variations in the onset and healing rates of venous leg ulcers

2010 ◽  
Vol 25 (1) ◽  
pp. 29-34 ◽  
Author(s):  
M Simka
Keyword(s):  
Time Series ◽  
Immune System ◽  
Seasonal Variations ◽  
Venous Insufficiency ◽  
Venous Ulcer ◽  
Leg Ulcers ◽  
Case Histories ◽  
Retrospective Survey ◽  
Venous Ulcers ◽  
Strong Seasonality

Objectives As many vascular pathologies exhibit circannual fluctuation, the aim of this study was to assess the chronobiological features of venous ulcers. Methods Based on a retrospective survey of the case histories of 391 venous ulcer patients, the rates of ulcer onset and healing in each month were analysed statistically; a time series was constructed to evaluate the seasonality. Results There was a significantly higher frequency of ulcer onset during the warmer part of the year (April–October), and onset showed strong seasonality. Healing rates were also unequally and statistically significantly distributed throughout the year: ulcers that appeared or that were treated with specialized treatment in the winter or summer healed slower in comparison to ulcers that began in the spring or autumn. Conclusions Venous ulcers exhibit circannual fluctuations in their onset and healing rates. Hypothetically, in addition to exacerbation of chronic venous insufficiency, seasonal variations in immune system activity might potentially be responsible for this phenomenon.

Subcutaneous fasciotomy and eradication of superficial venous reflux for chronic and recurrent venous ulcers: mid-term results

2011 ◽  
Vol 26 (5) ◽  
pp. 197-202 ◽  
Author(s):  
J T Christenson ◽  
C Prins ◽  
G Gemayel
Keyword(s):  
Ulcer Healing ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Subcutaneous Tissue ◽  
Skin Grafting ◽  
Venous Ulcer ◽  
Venous Disease ◽  
Ulcer Recurrence ◽  
Venous Ulcers ◽  
Mid Term Results

Objective Increased intramuscular and subcutaneous tissue pressures are often found in patients with severe chronic venous insufficiency venous ulcer disease. Additional subcutaneous para-tibial fasciotomy promotes early ulcer healing. This study evaluates the mid-term effect of eradication of superficial reflux with additional fasciotomy in patients with increased tissue pressures. Method Between January 2006 and June 2009, 58 patients underwent fasciotomy. Tissue pressures (intramuscular and subcutaneous) were measured. Sixty-nine limbs with 91 venous ulcers were treated. Mean duration of the venous ulcer was 3.4 years. Underlying disease was post-thrombotic syndrome (PT) in 19 patients (33%, 24 limbs, 27 ulcers) and non-post-thrombotic (non-PT) severe chronic venous insufficiency in 39 (67%, 45 limbs, 64 ulcers). All patients were C6 at the time of surgery. Preoperative tissue pressures were 23.5 ± 6.1 mmHg (intramuscularly) and 9.8 ± 3.2 mmHg (subcutaneously). Results Ninety ulcers (99%) healed postoperatively (42 with and 48 without skin grafting). Tissue pressures significantly decreased following surgery and remained low at three months postoperatively. Ten ulcers in six patients recurred six to 20 months postoperatively (11%), resulting in 86.4 actuarial freedom from venous ulcer recurrence at three years following surgery. Four patients (1 non-PT and 3 PT) had re-fasciotomy; all healed initially but two ulcers (2 patients, PT) recurred at 11 and 12 months. Those patients underwent re-fasciotomy, one healed and one recurred six months later. Conclusion Eradication of superficial reflux with additional subcutaneous fasciotomy for chronic and recurrent venous ulcer improves ulcer healing or success of skin grafting. Mid-term results are excellent particularly in patients with non-PT disease. Recurrence is more frequently seen in patients with PT syndrome. In patients with ulcer recurrence and high tissue pressures, re-fasciotomy can be helpful to promote healing, particularly in patients with primary venous disease.

scholarly journals Role of Panchvalkala Kwatha Dhawana Karma in the management of non-healing varicose ulcer – A case study

2021 ◽  
Vol 5 (02) ◽  
Author(s):  
Umesh Mohite ◽  
Mukund D. Magare
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Ulcer Formation ◽  
Venous Valve ◽  
Venous Valves ◽  
Venous Ulcers ◽  
Varicose Ulcer ◽  
Healing Wounds

ABSTRACT               Venous ulcers (varicose ulcers or stasis ulcers) are the wounds occurring due to inappropriate functioning of venous valves, commonly of legs. It is most common and serious chronic venous insufficiency complication. The overall incidence rate is 0.76% in men and 1.42% in women. When venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the vein that leads to hypertension, which stretches the veins resulting in ulcer formation. If not treated properly, the ulcers may get infected leading to cellulitis or gangrene and eventually may need amputation of the part of limb.               In Ayurvedic prospective, varicose ulcers can be correlated with ‘Siragata Dushta Vrana’. Acharya Sushruta has advocated the Shashthi upakrama 1 (60 procedures) for treating the dushta vrana, among which Dhawana/ Parishek2 become third upakrama/procedure that means parishek procedure is included in first top 3 procedures and is useful in infected and non-healing wounds.               Patients with varicose ulcers was advised to take ‘Sukshma Triphala’ internally and ‘Panchavalkala Kwatha Dhawana’ over lower limb daily twice a day followed by cleaning and dressing of wound which proved very effective and the ulcer healed completely in 30 days.  

Venous intervention in chronic venous ulcer treatment and recurrence avoidance

Phlebologie ◽  
2016 ◽  
Vol 45 (03) ◽  
pp. 135-139
Author(s):  
N. Morrison
Keyword(s):  
Venous Insufficiency ◽  
Ulcer Patient ◽  
Venous Ulcer ◽  
Venous Intervention ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Pump Failure ◽  
Venous Ulcers ◽  
Superficial Venous Insufficiency

SummaryIn this brief overview I will progress from superficial venous intervention for venous leg ulcers (VLU) to perforator intervention and finally to deep venous intervention. But first there are a number of concepts that must be accepted. We know that 70 % of patients with leg ulcers have a venous component (1), and in at least 40 % of those patients, ulcers will be caused by superficial venous insufficiency alone or in combination with perforator incompetence (2). Such patients will likely benefit from treatment of their superficial venous disease.One of the most important but often overlooked factors in venous ulcers is calf pump failure. Simka has reported that 45 % of patients with venous ulcers have calf pump failure (3).Thorough duplex evaluation of the venous leg ulcer patient is paramount for accurate diagnosis, the differentiation between arterial and venous components (purely arterial, venous, or mixed etiology), and the obstructive and/or incompetent nature and location of venous lesions. In obstructive venous lesions the degree of obstruction as well as how proximal the lesion extends must be known. For venous insufficiency the location (deep and/or superficial venous system) and the extent (segmental or axial) will help determine how much the incompetence contributes to the overall ulcer condition, and what lesions can be safely treated.

Medidas para prevenção de recidivas de úlceras venosas

2020 ◽  
Vol 10 (31) ◽  
pp. 96-104
Author(s):  
Caroline Muller Almeida ◽  
Suelen Elias da Veiga Freitas ◽  
Aline Affonso Luna ◽  
Cintia Silva Fassarella ◽  
Priscilla Alfradique de Souza
Keyword(s):  
Relapse Prevention ◽  
Selection Criteria ◽  
Preventive Measures ◽  
Venous Ulcer ◽  
Limiting Factor ◽  
Venous Ulcers ◽  
Ulcer Relapse ◽  
Varicose Ulcer ◽  
Key Word ◽  
Review Study

Identificar e analisar evidências científicas adotadas na prevenção de recidivas de úlceras venosas. Trata-se de um estudo de revisão integrativa da literatura, descritivo, de abordagem qualitativa, realizado entre outubro e novembro de 2017, a partir de consulta de bases de dados nacionais e internacionais. Os descritores utilizados foram “úlcera venosa”, “úlcera varicosa”, “recidiva” associados à palavra chave “prevenção”. Recorreu análise temática de conteúdo, emergindo duas categorias. Dos 305 artigos encontrados, 10 foram selecionados atendendo aos critérios de seleção. As principais evidências observadas foram “medidas para a prevenção de recidivas de úlceras venosas” e “facilidades e dificuldades da implementação de medidas preventivas”. Evidenciou-se que as medidas são diversas para prevenir as recidivas de úlcera venosa, no entanto, a adesão ainda é fator limitador as práticas devido à complexidade que a envolve.Descritores: Úlcera Venosa, Recidiva, Prevenção. Measures to prevent recurrence of venous ulcersAbstract: To identify and analyze scientific evidences adopted in the prevention of venous ulcers recurrences. It is an integrative literature review study, descriptive, with a qualitative approach, carried out between October and November 2017, based on consultation of national and international databases. The descriptors used were "venous ulcer", "varicose ulcer", "relapse" associated with the key word "prevention". It resorted to thematic analysis of content, emerging two categories. Of the 305 articles found, 10 were selected according to the selection criteria. The main evidences observed were "measures for the prevention of relapses of venous ulcers" and "facilities and difficulties of the implementation of preventive measures". It was evidenced that the measures are diverse to prevent the recurrence of venous ulcer, however, adherence is still a limiting factor to the practices due to the complexity that involves it.Descriptors: Venous Ulcer, Relapse, Prevention. Medidas para la prevención de recidivas de úlceras venosasResumen: Identificar y analizar evidencias científicas adoptadas en la prevención de recidivas de úlceras venosas. Este es un estudio integrador de revisión de literatura, descriptivo, con un enfoque cualitativo, realizado entre octubre y noviembre de 2017, basado en la consulta de bases de datos nacionales e internacionales. Los descriptores utilizados fueron "úlcera venosa", "úlcera varicosa", "recidiva" asociados a la palabra clave "prevención". Se recurrió análisis temático de contenido, emergiendo dos categorías. De los 305 artículos encontrados, 10 fueron seleccionados atendiendo a los criterios de selección. Las principales evidencias observadas fueron "medidas para la prevención de recidivas de úlceras venosas" y "facilidades y dificultades de la aplicación de medidas preventivas". Se evidenció que las medidas son diversas para prevenir las recidivas de úlcera venosa, sin embargo, la adherencia todavía es factor limitante en las prácticas debido a la complejidad que la envuelve.Descriptores: Úlcera Varicosa, Recurrencia, Prevención.

Lymphatico‐venous anastomosis in chronic ulcer with venous insufficiency: A case report

Microsurgery ◽  
2021 ◽  
Author(s):  
Emanuele Cigna ◽  
Diletta Maria Pierazzi ◽  
Simone Sereni ◽  
Marco Marcasciano ◽  
Luigi Losco ◽  
...  
Keyword(s):  
Case Report ◽  
Venous Insufficiency ◽  
Chronic Ulcer ◽  
Venous Anastomosis

scholarly journals Efficacy of treatment modalities for venous insufficiency patients with venous ulcers

2021 ◽  
Vol 9 (5) ◽  
pp. 1350
Author(s):  
Mehmet Senel Bademci ◽  
Cemal Kocaaslan ◽  
Fatih Avni Bayraktar ◽  
Ahmet Oztekin ◽  
Huseyin Bilal Aydin ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Treatment Modalities ◽  
Venous Ulcers ◽  
Efficacy Of Treatment

Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

2022 ◽  
pp. 153473462110659
Author(s):  
Michele Neves Brajão Rocha ◽  
Carol Viviana Serna Gonzalez ◽  
Eline Lima Borges ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Soraia Assad Nasbine Rabeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Onset Time ◽  
Venous Ulcer ◽  
High Recurrence Rate ◽  
Ulcer Recurrence ◽  
Clinical Approach ◽  
Historical Cohort ◽  
Venous Ulcers

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

Changes in Microcirculation in Venous Ulcers with Essaven Gel

Angiology ◽  
2001 ◽  
Vol 52 (3_suppl) ◽  
pp. S23-S27 ◽  
Author(s):  
L. Incandela ◽  
G. Belcaro ◽  
M.R. Cesarone ◽  
M.T. De Sanctis ◽  
M. Griffin
Keyword(s):  
Placebo Group ◽  
Treatment Group ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Local Treatment ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Single Application ◽  
Venous Ulcers

Microcirculatory changes in chronic venous insufficiency (CVI) due to venous hypertension produce venous hypertensive microangiopathy (VHM) and lead to ulceration. VHM is charac terized by enlarged, convoluted capillaries; increase in flux, permeability, and edema; and altered microlymphatics. PO2 is decreased and CO2 increased. Capillary exchanges are altered and nutritional alterations in association with microtrauma may cause venous ulcers. The aim of this pilot, cross-over, randomized, placebo-controlled study was to evaluate the effect of local treatment with Essaven gel (EG) (single acute application) in 10 subjects with VHM and venous ulcers. The study was structured over 3 days: day 1 was used for the control evalua tion for all patients. One group was randomized for the sequence placebo (day 2) and EG the following day; the second group with the sequence EG (day 2) and placebo (day 3). Indepen dently from the sequence, measurements of flux and PO2 in standard conditions showed positive changes (significant decrease of the abnormally increased flux, PO2 increase) in the EG treatment group. Changes in the placebo group were limited and associated with skin manip ulation. In conclusion, EG acutely improves microcirculation in limbs with VHM and ulceration even with a single application.

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