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Venous leg ulcers

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https://www.readbyqxmd.com/read/28078355/-compression-therapy-of-venous-leg-ulcers-in-the-decongestion-phase
#1
REVIEW
J Dissemond, S Eder, S Läuchli, H Partsch, M Stücker, W Vanscheidt
Compression therapy is the basis for successful treatment in most patients with venous leg ulcers. Concerning compression therapy, the initial phase of decongestion and the following phase of maintenance should be differentiated. While in the maintenance phase (ulcer) stocking systems are now frequently recommended, in the decongestion phase compression bandages are mostly still used, which however are often inappropriately applied. In German-speaking countries, compression therapy with short-stretch bandages has a long tradition...
January 11, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28077026/a-case-control-study-of-risk-factors-of-chronic-venous-ulceration-in-patients-with-varicose-veins
#2
Gohar Abelyan, Lusine Abrahamyan, Gayane Yenokyan
Background/objectives Venous ulcers carry psychological and high financial burden for patients, causing depression, pain, and limitation of mobility. The study aimed to identify factors associated with an increased risk of venous ulceration in patients with varicose veins in Armenia. Methods A case-control study design was utilized enrolling 80 patients in each group, who underwent varicose treatment surgery in two specialized surgical centers in Armenia during 2013-2014 years. Cases were patients with varicose veins and venous leg ulcers...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28073316/clinical-implications-of-the-anatomical-variation-of-deep-venous-thrombosis
#3
Ayman El-Menyar, Mohammad Asim, Gaby Jabbour, Hassan Al-Thani
Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#4
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/28063868/distinct-wound-healing-and-quality-of-life-outcomes-in-subgroups-of-patients-with-venous-leg-ulcers-with-different-symptom-cluster-experiences
#5
Kathleen Finlayson, Christine Miaskowski, Kimberly Alexander, Wei-Hong Liu, Bradley Aouizerat, Christina Parker, Dianne Maresco-Pennisi, Helen Edwards
CONTEXT: Adults with venous leg ulcers frequently experience multiple symptoms which may influence quality of life (QOL). OBJECTIVES: To identify patient subgroups based on their experience with a pain-depression-fatigue-sleep disturbance (PDFS) symptom cluster and to identify differences in patient characteristics, as well as wound healing and quality of life outcomes between the subgroups. METHODS: Secondary data analysis from previous longitudinal studies of 247 patients with venous leg ulcers...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060003/clinical-characteristics-of-mixed-arteriovenous-leg-ulcers-a-descriptive-study
#6
Joseph A Marin, Kevin Y Woo
PURPOSE: The purpose of this study was to identify the clinical characteristics of mixed arteriovenous leg ulcers (MLU) that differentiated them from venous leg ulcers (VLU). DESIGN: Secondary analysis of data from larger electronic database. SUBJECTS AND SETTING: The sample comprised 1007 persons with lower extremity ulcers. Two hundred sixty three individuals with MLU were compared to 744 individuals with VLU; their ankle brachial indices were 0...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28056702/management-of-venous-ulcers-according-to-their-anatomical-relationship-with-varicose-veins
#7
Yun-Nan Lin, Tung-Ying Hsieh, Shu-Hung Huang, Chia-Ming Liu, Kao-Ping Chang, Sin-Daw Lin
Background Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer. Method In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised. Result The varicose veins were traced to the base or periphery of the 55 ulcers...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28053158/a-bioengineered-living-cell-construct-activates-an-acute-wound-healing-response-in-venous-leg-ulcers
#8
Rivka C Stone, Olivera Stojadinovic, Ashley M Rosa, Horacio A Ramirez, Evangelos Badiavas, Miroslav Blumenberg, Marjana Tomic-Canic
Chronic nonhealing venous leg ulcers (VLUs) are widespread and debilitating, with high morbidity and associated costs; about $15 billion is spent annually on the care of VLUs in the United States. Despite this, there is a paucity of treatments for VLUs because of the lack of pathophysiologic insight into ulcer development as well as the lack of knowledge regarding biologic actions of existing VLU-targeted therapies. The bioengineered bilayered living cellular construct (BLCC) skin substitute is a U.S. Food and Drug Administration-approved biologic treatment for healing VLUs...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28038742/ibuprofen-loaded-pva-chitosan-membranes-a-highly-efficient-strategy-towards-an-improved-skin-wound-healing
#9
Patrícia I Morgado, Sónia P Miguel, Ilídio J Correia, Ana Aguiar-Ricardo
During wound healing, an early inflammation can cause an increase of the wound size and the healing process can be considerably belated if a disproportionate inflammatory response occurs. (S)-ibuprofen (IBP), a non-steroidal anti-inflammatory agent, has been used for muscle healing and to treat venous leg ulcers, but its effect in skin wound healing has not been thoroughly studied thus far. Herein, IBP-β-cyclodextrins carriers were designed to customise the release profile of IBP from poly(vinyl alcohol)/chitosan (PVA/CS) dressings in order to promote a faster skin regeneration...
March 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/27994330/a-prospective-study-in-comparison-of-ambulatory-phlebectomy-and-duplex-guided-foam-sclerotherapy-in-the-management-of-varicosities-with-isolated-perforator-incompetence
#10
R Kishore, T Bavani Sankar, A Anandi, S Nedunchezhian, Valarmathy Murugan
Perforators are those which connect the superficial and deep venous system either directly to main veins or indirectly through the muscular and soleal venous plexus. The emergence of minimally invasive techniques like ambulatory phlebectomy (AP) and foam sclerotherapy (FS) has led to increasing interest about the appropriate therapy for the treatment of isolated perforator incompetence. There have been no studies which have compared the effectiveness of these in-office procedures in isolated perforator incompetence due to the low prevalence of cases...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27992134/compression-therapy-current-practice-of-care-level-of-knowledge-in-patients-with-venous-leg-ulcers
#11
Kerstin Protz, Kristina Heyer, Joachim Dissemond, Barbara Temme, Karl-Christian Münter, Ida Verheyen-Cronau, Katharina Klose, Carsten Hampel-Kalthoff, Matthias Augustin
BACKGROUND AND OBJECTIVES: Compression therapy is a mainstay in the causal treatment of patients with venous leg ulcers. It facilitates healing, reduces pain and recurrences, and increases quality of life. Up until now, there is a scarcity of scientific data with respect to the level of care and the specific knowledge of patients with venous leg ulcers. PATIENTS AND METHODS: At first presentation, patients with venous leg ulcers anonymously answered a standardized questionnaire...
December 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27987244/aspirin-treatment-for-chronic-wounds-potential-beneficial-and-inhibitory-effects
#12
Ian Andrew Darby, Carolina Dragica Weller
Aspirin is a generally well-tolerated drug that is now widely used in aged patients for its anti-thrombotic action. Aspirin works through several pathways to reduce inflammation, fever and to alter platelet activity. The scientific literature suggests that inhibition of the cyclooxygenase enzymes by aspirin or other nonsteroidal anti-inflammatory drugs may be deleterious to normal wound repair processes and result in healing inhibition. However, novel effects of aspirin on other pathways that regulate inflammation and repair have been reported more recently...
December 17, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27977053/protease-modulating-matrix-treatments-for-healing-venous-leg-ulcers
#13
REVIEW
Maggie J Westby, Gill Norman, Jo C Dumville, Nikki Stubbs, Nicky Cullum
BACKGROUND: Venous leg ulcers (VLUs) are open skin wounds on the lower leg that occur because of poor blood flow in the veins of the leg; leg ulcers can last from weeks to years, and are both painful and costly. Prevalence in the UK is about 2.9 cases per 10,000 people. First-line treatment for VLUs is compression therapy, but around 60% of people have unhealed ulcers after 12 weeks' treatment and about 40% after 24 weeks; therefore, there is scope for further improvement. Limited evidence suggests non-healing leg ulcers may have persisting elevated levels of proteases, which is thought to deter the later stages of healing; thus, timely protease-modulating matrix (PMM) treatments may improve healing by physically removing proteases from the wound fluid...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27974009/therapeutic-effectiveness-of-a-calendula-officinalis-extract-in-venous-leg-ulcer-healing
#14
M Buzzi, F de Freitas, M de Barros Winter
OBJECTIVE: Non-healing venous leg ulcers (VLUs) have a significant effect on patients' quality of life and substantially increase expenditures in health-care systems. The aim of this study was to evaluate the clinical efficacy of the Calendula officinalis extract, Plenusdermax, in the treatment of VLUs. METHOD: Patients treated with Calendula officinalis extract (n=38) and control patients (n=19) were evaluated every two weeks for 30 weeks or until their ulcers healed...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27974007/impact-of-optimal-anticoagulation-therapy-on-chronic-venous-ulcer-healing-in-thrombophilic-patients-with-post-thrombotic-syndrome
#15
C A Hinojosa, S Olivares-Cruz, H Laparra-Escareno, S Sanchez-Castro, B Tamayo-Garcia, J E Anaya-Ayala
OBJECTIVE: Post-thrombotic syndrome (PTS) is the long-term sequelae of deep venous thrombosis (DVT). PTS clinical manifestations include chronic leg pain, oedema, lipodermatosclerosis and ulcers. The objective of this study is to determine in patients with documented history of thrombophilias and DVT whether the number of previous thrombotic events and optimal anticoagulation therapy are associated with the time to venous ulcer healing following the start of compression therapy. METHOD: Retrospective analysis performed in thrombophilic patients under the age of 50 years old with chronic venous ulcers secondary to DVT at the wound clinic in the National Institute of Medical Sciences and Nutrition 'Salvador Zubirán ' in Mexico City...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27943665/combination-therapy-of-autologous-adipose-mesenchymal-stem-cell-enriched-high-density-lipoaspirate-and-topical-timolol-for-healing-chronic-wounds
#16
Larissa Larsen, Catherine N Tchanque-Fossuo, Farzam Gorouhi, David Bodreault, Chuong Nguyen, Robert W Crawford, Sara E Dahle, Thomas Whetzel, R Rivkah Isseroff
Chronic venous leg ulcers are profoundly debilitating and result in billions of health care expenditures. Thus, there is a quest for engineered and innovative approaches. Herein we present a 63 year-old patient with a 30-year history of venous stasis and left lower extremity ulcers, which have been refractory to standard of care, anticoagulation, and venous stripping. The medial ulcer was treated with transplantation of autologous adipose mesenchymal stem cell (AMSC)-enriched, high density lipoaspirate (HDL) on OASIS wound matrix, and compression therapy...
December 12, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27941577/stress-illness-perceptions-behaviours-and-healing-in-venous-leg-ulcers-findings-from-a-prospective-observational-study
#17
Jessica Walburn, John Weinman, Sam Norton, Matthew Hankins, Karen Dawe, Bolatito Banjoko, Kavita Vedhara
OBJECTIVE: To investigate the impact of stress, illness perceptions and behaviours on healing of venous leg ulcers. METHODS: A prospective observational study of 63 individuals for 24 weeks investigated possible psychosocial predictors of healing. There were two indices of healing: rate of change in ulcer area and number of weeks to heal. Psychological variables were assessed at baseline using self-report measures (Perceived Stress Scale, Hospital Anxiety and Depression Scale, Revised Illness Perception Questionnaire, adapted Summary of Diabetes Self-Care Activities, Adherence Questionnaire and Short-Form Health Survey)...
December 9, 2016: Psychosomatic Medicine
https://www.readbyqxmd.com/read/27936243/can-wound-exudate-from-venous-leg-ulcers-measure-wound-pain-status-a-pilot-study
#18
Taichi Goto, Nao Tamai, Gojiro Nakagami, Aya Kitamura, Ayumi Naito, Masayuki Hirokawa, Chisako Shimokawa, Kazuo Takahashi, Junichi Umemoto, Hiromi Sanada
We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity) and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score)...
2016: PloS One
https://www.readbyqxmd.com/read/27922784/venous-leg-ulcers-appropriate-diagnosis-and-evidence-based-treatment
#19
Linda Nazarko
Each year around £3.3 billion is spent on wound care in the community. Community nurses care for around 730 000 with leg ulcers each year and around 284 000 people still have a leg ulcer after a year. This article explores the issue of hard to heal leg ulcers and what community nurses can do to improve healing rates and improve quality of life for people with leg ulcers.
December 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27914110/physical-exercise-for-the-treatment-of-non-ulcerated-chronic-venous-insufficiency
#20
REVIEW
Diego N Araujo, Cibele Td Ribeiro, Alvaro Cc Maciel, Selma S Bruno, Guilherme Af Fregonezi, Fernando Al Dias
BACKGROUND: Chronic venous insufficiency (CVI) is a common disease that causes discomfort and impairs the quality of life of affected persons. Treatments such as physical exercise that aim to increase the movement of the ankle joint and strengthen the muscle pump in the calf of the leg may be useful to reduce the symptoms of CVI. OBJECTIVES: To assess and summarise the existing clinical evidence on the efficacy and safety of physical exercise programmes for the treatment of individuals with non-ulcerated CVI...
3, 2016: Cochrane Database of Systematic Reviews
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