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Venous leg ulcers

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https://www.readbyqxmd.com/read/28798504/molecular-aspects-of-wound-healing-and-the-rise-of-venous-leg-ulceration-omics-approaches-to-enhance-knowledge-and-aid-diagnostic-discovery
#1
REVIEW
Daniel A Broszczak, Elizabeth R Sydes, Daniel Wallace, Tony J Parker
Chronic wounds, in particular venous leg ulcers (VLU), represent a substantial burden for economies, healthcare systems and societies worldwide. This burden is exacerbated by the recalcitrant nature of these wounds, despite best practice, evidence-based care, which substantially reduces the quality of life of patients. Furthermore, co-morbidities such as diabetes and cardiovascular disease within ageing populations further contribute to the increasing prevalence in developed countries. This review provides an overview of the literature concerning the cellular and molecular mechanisms of wound healing and aspects where this process fails, resulting in a chronic wound...
February 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28795880/concordance-and-acceptability-of-electric-stimulation-therapy-a-randomised-controlled-trial
#2
C Miller, W McGuiness, S Wilson, K Cooper, T Swanson, D Rooney, N Piller, M Woodward
OBJECTIVE: A pilot single-blinded randomised controlled trial (RCT) was conducted to examine concordance with and acceptability of electric stimulation therapy (EST) in patients with venous leg ulcers (VLUs) who had not tolerated moderate to high compression. METHOD: Participants were randomised to the intervention group (n=15) or a placebo control group (n=8) in which EST was used four times daily for 20 minutes per session. Participants were monitored for eight weeks during which time concordance with the treatment and perceptions of the treatment were assessed...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28793373/reflection-on-the-cause-and-avoidance-of-recurrent-venous-leg-ulcers-an-interpretive-descriptive-approach
#3
Ann Stewart, Helen Edwards, Kathleen Finlayson
AIMS AND OBJECTIVES: To gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated. BACKGROUND: Venous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792833/volume-reduction-of-the-limb-and-venous-leg-ulcer-healing
#4
Alexandra Bishop
No abstract text is available yet for this article.
August 10, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28777054/an-investigation-of-skin-perfusion-in-venous-leg-ulcer-after-exercise
#5
Omar Mutlak, Mohammed Aslam, Nigel J Standfield
INTRODUCTION: A venous leg ulcer (VLU) has a major impact on the quality of life and functional ability of individuals, but no single treatment is yet effective. This study investigates the changes induced by dorsiflexion exercise on skin perfusion in VLU patients to achieve a better understanding of venous ulcer pathophysiology. METHODS: Seventy-eight venous leg ulcer patients were randomised into four groups. The non-exercise groups included a control group (n = 18) and a compression therapy group (n = 20) and the exercise groups included an exercise-only group (n = 20) and a compression and exercise group (n = 20)...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28770561/evaluation-of-a-muscle-pump-activating-device-for-non-healing-venous-leg-ulcers
#6
Connie Harris, Rochelle Duong, Gwen Vanderheyden, Beth Byrnes, Renee Cattryse, Ava Orr, David Keast
This evaluation involves an innovative muscle pump-activating device (geko™) as an adjunctive therapy with best practices for non-healing venous leg ulcers (VLUs). Stimulating the common peroneal nerve (at the fibular head), the geko™ device creates a response that acts as foot and calf muscle pumps, increasing venous, arterial and microcirculatory flow. The aim was to evaluate and determine if the geko™ is effective in this population and if it should be added to the medical supply formulary. In all, 12 patients with 18 recalcitrant VLUs (defined as less than 30% reduction in wound size in 30 days with best practices) in two community settings in Ontario consented to the evaluation and were treated with the geko™ for up to 20 weeks...
August 2, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#7
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28758717/epa%C3%A2-%C3%A2-dha-supplementation-reduces-pmn-activation-in-microenvironment-of-chronic-venous-leg-ulcers-a-randomized-double-blind-controlled-study
#8
Jodi C McDaniel, Laura Szalacha, Michelle Sales, Sashwati Roy, Scott Chafee, Narasimham Parinandi
Sustained high levels of activated polymorphonuclear leukocytes (PMNs) and PMN-derived proteases in the microenvironment of chronic venous leg ulcers (CVLUs) are linked to chronic inflammation and delayed healing. Uncontrolled PMN activity eventually destroys newly developed tissue and degrades critical growth factors. The bioactive components of fish oil (n-3 eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) have strong inflammation-resolving actions and have been shown to assuage PMN activity, but have not been tested in CVLU patients...
July 31, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28750144/therapy-of-ulcus-cruris-of-venous-and-mixed-venous-arterial-origin-with-autologous-adult-native-progenitor-cells-from-subcutaneous-adipose-tissue-a-prospective-clinical-pilot-study
#9
A Konstantinow, A Arnold, K Djabali, W Kempf, J Gutermuth, T Fischer, T Biedermann
BACKGROUND: The stromal vascular fraction (SVF) of adipose tissue consists of cellular subpopulations with distinct regenerative potential. OBJECTIVE: To investigate the regenerative capacities of autologous SVF cells in the treatment of chronic leg ulcers of venous (VLU) and arterial-venous (AVLU) origin. METHODS: Multimorbid ulcer patients received a singular topical treatment with 9-15x10(6) SVF cells, separated from abdominal lipoaspirates by digestion with collagenase and dispase and applied immediately after isolation...
July 27, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28747258/confidence-and-clinical-judgement-in-community-nurses-managing-venous-leg-ulceration-a-judgement-analysis
#10
Una J Adderley, Carl Thompson
BACKGROUND: The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned. OBJECTIVES: To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration. DESIGN: Judgement Analysis. SETTING: UK community and primary care nursing services...
July 19, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28730726/changes-in-the-extracellular-matrix-surrounding-human-chronic-wounds-revealed-by-2-photon-imaging
#11
Jessica E S Sutcliffe, Christopher Thrasivoulou, Thomas E Serena, Leigh Madden, Toby Richards, Anthony R J Phillips, David L Becker
Chronic wounds are a growing problem worldwide with no effective therapeutic treatments available. Our objective was to understand the composition of the dermal tissue surrounding venous leg ulcers and diabetic foot ulcers (DFU). We used novel 2-photon imaging techniques alongside classical histology to examine biopsies from the edges of two common types of chronic wound, venous leg ulcers and DFU. Compared to normal intact skin, we found that collagen levels are significantly reduced throughout the dermis of venous leg ulcer biopsies and DFU, with a reduction in both fibril thickness and abundance...
July 20, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28727481/leucocyte-and-platelet-rich-fibrin-l-prf-as-a-regenerative-medicine-strategy-for-the-treatment-of-refractory-leg-ulcers-a-prospective-cohort-study
#12
Nelson R Pinto, Matias Ubilla, Yelka Zamora, Verónica Del Rio, David M Dohan Ehrenfest, Marc Quirynen
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients...
July 20, 2017: Platelets
https://www.readbyqxmd.com/read/28712679/the-molecular-biology-in-wound-healing-non-healing-wound
#13
REVIEW
Chun Qing
The development of molecular biology and other new biotechnologies helps us to recognize the wound healing and non-healing wound of skin in the past 30 years. This review mainly focuses on the molecular biology of many cytokines (including growth factors) and other molecular factors such as extracellular matrix (ECM) on wound healing. The molecular biology in cell movement such as epidermal cells in wound healing was also discussed. Moreover many common chronic wounds such as pressure ulcers, leg ulcers, diabetic foot wounds, venous stasis ulcers, etc...
June 30, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28704156/quality-of-life-in-patients-with-leg-ulcers-results-from-challenge-a-double-blind-randomised-controlled-trial
#14
S Meaume, A Dompmartin, C Lok, I Lazareth, M Sigal, F Truchetet, A Sauvadet, S Bohbot
OBJECTIVE: We recently showed the superiority of a matrix metalloproteinase (MMP) modulating dressing (foam impregnated with NOSF, nano-oligosaccharide factor) compared with a lipidocolloid matrix (TLC) control dressing in median wound area reduction (WAR). Here we report the results from the same study assessing the performance and safety of TLC-NOSF in the local management of venous leg ulcers (VLUs) or mixed leg ulcers and determining its impact on the patient's health-related quality of life (HRQoL)...
July 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28702982/chronic-inflammation-therapy-combined-with-low-dose-cytokines-in-the-treatment-of-chronic-ulcers-of-lower-limbs
#15
S E Aragona, P Amori, G Mereghetti, J Lotti, T Lotti, G V L Colombo
Prevalence of chronic venous leg ulcers has increased from 55% to 75% in 10 years. We treat chronic vascular lesions according to a cyclic multiphase method that follows the instrumental and differential etiologic diagnosis of ulcers of the lower limbs. The AIMED (Anti Inflammatory Regenerative Medicine) operating model follows the diagnostic phase and is structured in 5 interconnected phases. Mare evaluation, pH control, biofilm removal and prevention and infections are approached according to the International Guidelines...
July 13, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28702971/history-of-venous-leg-ulcers
#16
S Gianfaldoni, U Wollina, J Lotti, R Gianfaldoni, T Lotti, M G Roccia
To retrieve the history of venous ulcers and of skin lesions in general, we must go back to the appearance of human beings on earth. It is interesting to note that cutaneous injuries evolved parallel to human society. An essential first step in the pathogenesis of ulcers was represented by the transition of the quadruped man to Homo Erectus. This condition was characterized by a greater gravitational pressure on the lower limbs, with consequences on the peripheral venous system. Furthermore, human evolution was characterized by an increased risk of traumatic injuries, secondary to his natural need to create fire and hunt (e...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28682676/a-double-blind-placebo-controlled-randomized-evaluation-of-the-effect-of-low-level-laser-therapy-on-venous-leg-ulcers
#17
Julian Vitse, Farid Bekara, Stephanie Byun, Christian Herlin, Luc Teot
This study aimed to determine the effect of low-level laser therapy (LLLT) on chronic venous leg ulcers (VLUs). A double-blinded prospective randomized controlled trial was conducted to compare incidence of complete wound closure, ulcer size and pain reduction in patients randomized to 24 treatments of placebo or LLLT (635 nm) over 12 weeks. Patients presented with a 6-week history of VLUs ranging in size from 5 to 20 cm(2). Venous origin was confirmed by Doppler ultrasound and an ankle brachial index of 0...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28671410/venous-leg-ulcers
#18
E Andrea Nelson, Una Adderley
No abstract text is available yet for this article.
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28664657/refractory-venous-leg-ulcers-observational-evaluation-of-innovative-new-technology
#19
Connie Harris, Amanda Loney, Jillian Brooke, Amanda Charlebois, Lucy Coppola, Sowmil Mehta, Norman Flett
This observational case series reports the evaluation of a novel neuromuscular electrical stimulation device (geko™) that stimulates the common peroneal nerve at the fibular head as an adjunctive therapy in patients with non-healing venous leg ulcers. The aim was to evaluate and determine if the geko™ device was effective in this population and should be added to the medical supply formulary. Patients whose wounds had failed to heal within 24 weeks of standard therapy were identified in two community settings in Ontario...
June 30, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28656623/dosing-considerations-in-the-use-of-the-direct-oral-anticoagulants-in-the-antiphospholipid-syndrome
#20
J R Schofield, K Hassell
WHAT IS KNOWN AND OBJECTIVES: At least four prospective trials have been initiated investigating the direct oral anticoagulants in the antiphospholipid syndrome. Preliminary reports have supported their use in patients with a history of venous thrombosis and a target INR of 2-3, but there have also been reports of failure of these agents in the antiphospholipid syndrome. The objective is to present a case report that illustrates there may be important dosing issues when considering the use of these agents in patients with the antiphospholipid syndrome...
June 27, 2017: Journal of Clinical Pharmacy and Therapeutics
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