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Venous leg ulcers

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https://www.readbyqxmd.com/read/27922784/venous-leg-ulcers-appropriate-diagnosis-and-evidence-based-treatment
#1
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
#2
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...
December 3, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27913509/the-post-thrombotic-syndrome
#3
Susan R Kahn
The post-thrombotic syndrome (PTS) is a frequent, sometimes disabling complication of deep vein thrombosis (DVT) that reduces quality of life and is costly. This article discusses risk factors for PTS after DVT and available means to prevent and treat PTS, with a focus on new information in the field. After DVT, PTS will develop in 20% to 50% of patients, and severe PTS, including venous ulcers, will develop in 5% to 10%. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, persistent leg symptoms 1 month after acute DVT, obesity, and older age...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#4
REVIEW
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27886005/compression-in-the-treatment-of-chronic-venous-insufficiency-efficacy-depending-on-the-length-of-the-stocking
#5
Wolfgang Konschake, Helene Riebe, P Pediaditi, Hermann Haase, Michael Jünger, Stine Lutze
BACKGROUND: Below knee two-component compression stockings (AD) have revealed as effective for compression treatment of venous leg ulcers. Upto groin, thigh length stocking (AG) may enhance clinical effects, however wear comfort of these stocking may be affected. OBJECTIVE: venous haemodynamic in relation to the length of compression stockings. METHODS: A two-component AD stocking (37 mmHg) and two thigh length stockings (AG 37, with an interface pressure of 37 mmHg; AG 45, with an interface pressure of 45 mmHg) were tested by 16 patients with CVI...
November 23, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27879096/compression-therapy-in-patients-with-venous-leg-ulcers
#6
REVIEW
Joachim Dissemond, Bernd Assenheimer, Anke Bültemann, Veronika Gerber, Silvia Gretener, Elisabeth Kohler-von Siebenthal, Sonja Koller, Knut Kröger, Peter Kurz, Severin Läuchli, Christian Münter, Eva-Maria Panfil, Sebastian Probst, Kerstin Protz, Gunnar Riepe, Robert Strohal, Jürg Traber, Hugo Partsch
Wund-D.A.CH. is the umbrella organization of the various wound care societies in German-speaking countries. The present consensus paper on practical aspects pertinent to compression therapy in patients with venous leg ulcers was developed by experts from Germany, Austria, and Switzerland. In Europe, venous leg ulcers rank among the most common causes of chronic wounds. Apart from conservative and interventional wound and vein treatment, compression therapy represents the basis of all other therapeutic strategies...
November 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27868341/a-single-arm-trial-indirect-comparison-investigation-a-proof-of-concept-method-to-predict-venous-leg-ulcer-healing-time-for-a-new-acellular-synthetic-matrix-matched-to-standard-care-control
#7
Ronald Shannon, Andrea Nelson
To compare data on time to healing from two separate cohorts: one treated with a new acellular synthetic matrix plus standard care (SC) and one matched from four large UK pragmatic, randomised controlled trials [venous leg ulcer (VLU) evidence network]. We introduce a new proof-of-concept strategy to a VLU clinical evidence network, propensity score matching and sensitivity analysis to predict the feasibility of the new acellular synthetic matrix plus SC for success in future randomised, controlled clinical trials...
November 20, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27849283/social-repercussions-experienced-by-elderly-with-venous-ulcer
#8
Aline Cristiane de Sousa Azevedo Aguiar, Dora Sadigursky, Lucas Amaral Martins, Tânia Maria de Oliva Menezes, Alana Libânia de Souza Santos, Luana Araújo Dos Reis
Objective: Understand the social consequences experienced by elderly affected by venous ulcers. Methodology: descriptive and exploratory study with a qualitative approach carried out in 2012 with eight participants at a physiotherapy clinic in the state of Bahia. Data was collected through semi-structured interviews and analyzed through Bardin's thematic content analysis. Results: They showed that elderly patients with venous leg ulcers have become victims of prejudice, discrimination and have experienced embarrassment and shame in their daily routines because of the chronic wounds in their bodies, which makes than different from other people...
October 31, 2016: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/27830895/thrombolysis-for-acute-deep-vein-thrombosis
#9
REVIEW
Lorna Watson, Cathryn Broderick, Matthew P Armon
BACKGROUND: Standard treatment for deep vein thrombosis aims to reduce immediate complications. Use of thrombolysis or clot dissolving drugs could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the third update of a review first published in 2004. OBJECTIVES: To assess the effects of thrombolytic therapy and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function...
November 10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27827277/ulcer-area-reduction-at-2-weeks-predicts-failure-to-heal-by-24-weeks-in-the-venous-leg-ulcers-of-patients-living-alone
#10
C N Parker, K J Finlayson, H E Edwards
OBJECTIVE: Chronic wounds are costly and affect approximately 1-2% of the population. Venous disease is responsible for about 60% of all chronic leg ulcers and these ulcers can be debilitating, with evidence of a decreased quality of life. Unfortunately, up to 30% of venous leg ulcers (VLUs) fail to heal, despite best practice treatment. This study aimed to identify risk factors associated with delayed healing in participants with VLUs and in particular, whether psychosocial factors play a part in this process...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27811287/impact-of-uk-nice-clinical-guidelines-168-and-social-deprivation-on-access-to-interventional-treatment-for-symptomatic-varicose-vein-and-specialist-referral-for-leg-ulceration
#11
Huw Ob Davies, Matthew Popplewell, Gareth Bate, Lisa Kelly, Andreas Koutsoumpelis, Andrew W Bradbury
BACKGROUND: UK National Institute for Health and Care Excellence (NICE) clinical guidelines (CG) 168, published in July 2013, aimed to improve the management of lower limb venous disease by newly recommending interventional treatment for all people affected by symptomatic varicose veins (VV) and specialist vascular referral for all people suffering from a leg ulcer (LU) that had been present for ≥2 weeks. This study aims to determine if CG168 has increased access to vascular services, particularly for the socially deprived, who might be expected to have greater need for such services...
November 2, 2016: Phlebology
https://www.readbyqxmd.com/read/27771120/-retrospective-study-of-hypertensive-leg-ulcers-at-reims-university-hospital-epidemiological-clinical-disease-progression-data-effects-of-vitamin-k-antagonists
#12
P Nicol, P Bernard, P Nguyen, A Durlach, G Perceau
BACKGROUND: Hypertensive leg ulcers (HLU) are a form of necrotic leg ulcer. Their physiopathology is not well known and in these patients, no venous or arterial insufficiency is detected. The primary objective of this study was to evaluate the association between HLU severity and the presence or absence of concomitant vitamin K antagonist (VKA) medication. We furthermore aimed to describe the epidemiology of this entity and the prevalence of thrombophilia factors in this population. PATIENTS AND METHODS: This was a retrospective study in 54 patients hospitalized in the dermatology department of Reims University Hospital between 01/01/2007 and 31/12/2013: 23 patients were included in the "without VKA" group, and 30 were included in the "with VKA" group...
October 19, 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27745629/hair-follicle-containing-punch-grafts-accelerate-chronic-ulcer-healing-a-randomized-controlled-trial
#13
María-Luisa Martínez, Eduardo Escario, Enrique Poblet, David Sánchez, Fernando-Francisco Buchón, Ander Izeta, Francisco Jimenez
BACKGROUND: A prominent role of hair follicle-derived cells in epidermal wound closure is now well established but clinical translation of basic research findings is scarce. Although skin punch grafts have been used as a therapeutic intervention to improve healing of chronic leg ulcers, they are normally harvested from nonhairy areas, thus not taking advantage of the reported role of the hair follicle as a wound-healing promoter. OBJECTIVE: We sought to substantiate the role of hair follicles in venous leg ulcer healing by transplanting hair follicle-containing versus nonhairy punch grafts...
November 2016: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/27742997/bacterial-contribution-in-chronicity-of-wounds
#14
Kashif Rahim, Shamim Saleha, Xudong Zhu, Liang Huo, Abdul Basit, Octavio Luiz Franco
A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers...
October 14, 2016: Microbial Ecology
https://www.readbyqxmd.com/read/27717087/depressive-symptoms-in-patients-with-wounds-a-cross-sectional-study
#15
Kehua Zhou, Peng Jia
Depression slows wound healing in patients with chronic wounds. The prevalence of depressive symptoms differs in the literature and the current understandings of factors related to depression in patients with wounds have been limited. To investigate the prevalence of depressive symptoms and the associated factors in patients with wounds, we performed this retrospective study in which depressive symptoms were evaluated with the Patient Health Questionnaire 9-item (PHQ-9). Valid PHQ-9 scores were collected from 222 patients (112 males and 110 females; age: 64...
September 26, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27709618/the-wound-healing-trajectory-and-predictors-with-combined-electric-stimulation-and-conventional-care-one-outpatient-wound-care-clinic-s-experience
#16
Kehua Zhou, Ronald Schenk, Michael S Brogan
BACKGROUND: Electric stimulation (E-stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E-stim treatment. MATERIALS AND METHODS: This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E-stim and conventional care were included. The Kaplan-Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time...
December 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27706876/what-is-the-existing-evidence-supporting-the-efficacy-of-compression-bandage-systems-containing-both-elastic-and-inelastic-components-mixed-component-systems-a-systematic-review
#17
Lynn Welsh
AIM: To analyse current evidence on the efficacy of bandage systems containing both elastic and inelastic components (Mixed Component Systems MCSs). BACKGROUND: International consensus on the efficacy of types of compression systems is difficult to achieve; however MCSs are being promoted as combining the best properties of both elastic and inelastic bandage systems and increasingly being used to treat venous leg ulcers (VLUs) in practice. DESIGN: Systematic Literature Review...
October 5, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27695634/phenol-rich-compounds-sweet-gel-a-statistically-more-effective-antibiotic-than-cloxacillin-against-pseudomonas-aeruginosa
#18
Mehrab Dashtdar, Mohammad Reza Dashtdar, Babak Dashtdar, Gazala Afreen Khan, Karima Kardi
OBJECTIVES: The purpose of this study was to obtain a natural antibiotic from Phenol-rich compounds; for the dressing and the treatment of chronic wounds. METHODS: The Phenol-rich compound sweet gel was prepared by blending four natural herbal extracts, Acacia catechu (L.F.), Momia (Shilajit), Castanea sativa, and Ephedra sinica stapf, with combination of a sweet gel medium, including honey, maple saps, Phoenix dactylifera L. (date), pomegranate extract and Azadirachta indica gum as a stabilizer...
September 2016: Journal of Pharmacopuncture
https://www.readbyqxmd.com/read/27681589/effectiveness-of-hyaluronic-acid-and-its-derivatives-on-chronic-wounds-a-systematic-review
#19
A Shaharudin, Z Aziz
OBJECTIVE: Hyaluronic acid (HA) and its derivatives are used for chronic wounds, but evidence of their effectiveness remains unclear. The aim of this study was to provide more updated evidence for the effectiveness of HA (or its derivatives) compared with placebo or other agents for promoting healing in chronic wounds. METHOD: The Cochrane Central Register of Controlled Trials, MEDLINE via Ovid Online, CINAHL and the EMBASE via EBSCO host databases were searched...
October 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27666801/pulsatile-varicose-veins-secondary-to-severe-tricuspid-regurgitation-report-of-a-case-successfully-managed-by-endovenous-laser-treatment
#20
Shingo Chihara, Kentaro Sawada, Hiroshi Tomoeda, Shigeaki Aoyagi
We report a case of pulsatile varicose veins successfully managed by endovenous laser treatment (EVLT) of the great saphenous vein (GSV). A 77-year-old woman taking an anticoagulant was transferred to our hospital for pulsatile varicose veins complicated with repeated venous bleeding from an ulcer of her left lower leg. Doppler echocardiography showed severe tricuspid regurgitation, and duplex ultrasonography revealed an arterial-like pulsating flow in the saphenofemoral junction and along the GSV, but an arteriovenous fistula, obstruction of the deep veins, and the distal incompetent perforators were not detected...
September 22, 2016: Annals of Vascular Surgery
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