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https://www.readbyqxmd.com/read/28277996/venous-leg-ulcer-healing-with-electric-stimulation-therapy-a-pilot-randomised-controlled-trial
#1
C Miller, W McGuiness, S Wilson, K Cooper, T Swanson, D Rooney, N Piller, M Woodward
OBJECTIVE: Compression therapy is a gold standard treatment to promote venous leg ulcer (VLU) healing. Concordance with compression therapy is, however, often sub-optimal. The aim of this study was to evaluate the effectiveness of electric stimulation therapy (EST) to facilitate healing of VLUs among people who do not use moderate-to-high levels of compression (>25 mmHg). METHOD: A pilot multicentre, single-blinded randomised controlled trial was conducted. Participants were randomised (2:1) to the intervention group or a control group where EST or a sham device was used 4 times daily for 20 minutes per session...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102916/internet-based-learning-program-to-increase-nurses-knowledge-level-about-venous-leg-ulcer-care-in-home-healthcare
#2
Minna Ylönen, Jaakko Viljamaa, Hannu Isoaho, Kristiina Junttila, Helena Leino-Kilpi, Riitta Suhonen
AIM AND OBJECTIVE: To test the effectiveness of an internet-based education program about venous leg ulcer nursing care (eVLU) on perceived and theoretical knowledge levels and attitudes among nurses working in home healthcare. BACKGROUND: Nurses have been shown to have knowledge gaps in venous leg ulcer (VLU) nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment. DESIGN: Quasi-experimental study with pre- and post-measurements and nonequivalent intervention and comparison groups...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28060003/clinical-characteristics-of-mixed-arteriovenous-leg-ulcers-a-descriptive-study
#3
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/28053158/a-bioengineered-living-cell-construct-activates-an-acute-wound-healing-response-in-venous-leg-ulcers
#4
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/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
#5
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/27742997/bacterial-contribution-in-chronicity-of-wounds
#6
REVIEW
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...
April 2017: Microbial Ecology
https://www.readbyqxmd.com/read/27717087/depressive-symptoms-in-patients-with-wounds-a-cross-sectional-study
#7
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...
November 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27608512/multinational-pilot-audit-of-a-velcro-adjustable-compression-wrap-system-for-venous-and-lymphatic-conditions
#8
MULTICENTER STUDY
S Ehmann, J C Whitaker, S Hampton, A Collarte
OBJECTIVE: The aim of this small pilot audit was to record the performance of an adjustable Velcro compression wrap, ReadyWrap, and the experiences of patients and health-care professionals using the system as a self-care option for the management of venous and lymphatic leg conditions in both the treatment and maintenance phases. METHOD: This audit was held within a 4-week review period. Participants included venous leg ulcer (VLU) patients with and without oedema, and patients with lymphoedema...
September 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27594309/progressive-compression-versus-graduated-compression-for-the-management-of-venous-insufficiency
#9
Jan Shepherd
Venous leg ulceration (VLU) is a chronic condition associated with chronic venous insufficiency (CVI), where the most frequent complication is recurrence of ulceration after healing. Traditionally, graduated compression therapy has been shown to increase healing rates and also to reduce recurrence of VLU. Graduated compression occurs because the circumference of the limb is narrower at the ankle, thereby producing a higher pressure than at the calf, which is wider, creating a lower pressure. This phenomenon is explained by the principle known as Laplace's Law...
September 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27523653/antiseptic-with-modern-wound-dressings-in-the-treatment-of-venous-leg-ulcers-clinical-and-microbiological-aspects
#10
M Sopata, M Kucharzewski, E Tomaszewska
OBJECTIVE: To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. METHOD: Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level...
August 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27501073/prophylaxis-of-recurrent-venous-leg-ulcer
#11
K Kroeger, M Storck, P Kujath, E Rabe, J Dissemond
Venous leg ulcer (VLU) counts among the most common chronic wounds in Europe. Treatment is lengthy, cumbersome and costly, and there is a high rate of recurrence. This review shows the measures that should be offered to every patient with healed VLU to permanently prevent recurrence. To prevent VLU in case of varicose veins, the progression of chronic venous insufficiency (CVI) has to be stopped. There is convincing evidence that the effective treatment of varicose veins reduces the recurrence rate in patients with VLU...
August 8, 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27495869/phase-3-evaluation-of-hp802-247-in-the-treatment-of-chronic-venous-leg-ulcers
#12
Robert S Kirsner, Wolfgang Vanscheidt, David H Keast, John C Lantis, Cyaandi R Dove, Shawn M Cazzell, Mher Vartivarian, Matthias Augustin, William A Marston, Nicholas D McCoy, D Innes Cargill, Tommy D Lee, Jaime E Dickerson, Herbert B Slade
In 2012 we reported promising results from a Phase 2 clinical trial of HP802-247, a novel spray-applied investigational treatment for chronic venous leg ulcers (VLU) consisting of human, allogeneic fibroblasts and keratinocytes. We now describe Phase 3 clinical testing of HP802-247, its failure to detect efficacy, and subsequent investigation into the root causes of the failure. Two randomized, controlled trials enrolled a total of 673 adult outpatients at 96 centers in North America and Europe. The primary endpoint was the proportion of ulcers with confirmed closure at the end of 12 weeks of treatment...
August 6, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27478145/chronic-venous-disease-part-i-inflammatory-biomarkers-in-wound-healing
#13
Daniela Ligi, Giovanni Mosti, Lidia Croce, Joseph D Raffetto, Ferdinando Mannello
Venous leg ulcers (VLUs) produce wound fluid (WF), as a result of inflammatory processes within the wound. It is unclear if WF from different healing phases of VLU has a peculiar biochemical profile and how VLU microenvironment affects the wound healing mechanisms. This study was conducted to evaluate the cytokine/chemokine profiles in WF from distinct VLU phases, in WF- and LPS-stimulated monocytes and treated with glycosaminoglycan Sulodexide, a therapeutic option for VLU healing. WF and plasma were collected from patients with VLU during active inflammatory (Infl) and granulating (Gran) phases...
October 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27476154/recalcitrant-venous-leg-ulcers-may-heal-by-outpatient-treatment-of-venous-disease-even-in-the-presence-of-concomitant-arterial-occlusive-disease
#14
COMPARATIVE STUDY
G Mosti, A Cavezzi, G Massimetti, H Partsch
OBJECTIVE/BACKGROUND: Peripheral arterial occlusive disease (PAOD) is reported in about 15-20% of patients with venous leg ulcers (VLU). In such cases arterial recanalization is often recommended, and compression therapy is considered a contraindication when the ankle brachial pressure index (ABPI) is < 0.8. The aim of this study was to compare the outcome of patients with recalcitrant VLU, both without any arterial impairment ("pure venous recalcitrant leg ulcer" [pvRLU]) and with associated PAOD ("mixed arterial and venous recalcitrant leg ulcer" [mavRLU]), by treating only the venous disease...
September 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27460704/chronic-venous-disease-part-ii-proteolytic-biomarkers-in-wound-healing
#15
Daniela Ligi, Giovanni Mosti, Lidia Croce, Joseph D Raffetto, Ferdinando Mannello
Venous leg ulcers (VLU) are characterized by sustained proteolytic microenvironment impairing the healing process. Wound fluid (WF) reflect the biomolecular activities occurring within the wound area; however, it is unclear if WF from different healing phases have different proteolytic profiles and how VLU microenvironment affects the wound healing mechanisms. We investigated the proteolytic network of WF from distinct VLU phases, and in WF- and LPS-stimulated THP-1 monocytes treated with glycosaminoglycan sulodexide, a well known therapeutic approach for VLU healing...
October 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27318060/pharmacologic-treatment-to-improve-venous-leg-ulcer-healing
#16
Joseph D Raffetto, Robert T Eberhardt, Steven M Dean, Daniela Ligi, Ferdinando Mannello
Pharmacologic treatment for venous leg ulcers (VLUs) is an adjuvant treatment to compression therapy. It encompasses a variety of plant-derived and synthetic compounds with properties that alter venous microcirculation, endothelial function, and leukocyte activity to promote VLU healing. These compounds are often referred to as venotonics or venoactive drugs but have also been referred to as edema-protective agents, phlebotonics, vasoprotectors, phlebotropics, and venotropics. The exact mechanism of their ability to heal VLUs is not known; however, clinical trials support their efficacy...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27292202/management-of-patients-with-venous-leg-ulcers-challenges-and-current-best-practice
#17
Peter J Franks, Judith Barker, Mark Collier, Georgina Gethin, Emily Haesler, Arkadiusz Jawien, Severin Laeuchli, Giovanni Mosti, Sebastian Probst, Carolina Weller
Introduction It is well documented that the prevalence of venous leg ulcers (VLUs) is increasing, coinciding with an ageing population. Accurate global prevalence of VLUs is difficult to estimate due to the range of methodologies used in studies and accuracy of reporting. (1) Venous ulceration is the most common type of leg ulceration and a significant clinical problem, affecting approximately 1% of the population and 3% of people over 80 years of age (2) in westernised countries. Moreover, the global prevalence of VLUs is predicted to escalate dramatically, as people are living longer, often with multiple comorbidities...
June 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27210451/all-about-compression-a-literature-review
#18
Magali Rezende de Carvalho, Isabelle Silveira de Andrade, Alcione Matos de Abreu, Andrea Pinto Leite Ribeiro, Bruno Utzeri Peixoto, Beatriz Guitton Renaud Baptista de Oliveira
Lower extremity ulcers represent a significant public health problem as they frequently progress to chronicity, significantly impact daily activities and comfort, and represent a huge financial burden to the patient and the health system. The aim of this review was to discuss the best approach for venous leg ulcers (VLUs). Online searches were conducted in Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and reference lists and official guidelines. Keywords considered for this review were VLU, leg ulcer, varicose ulcer, compressive therapy, compression, and stocking...
June 2016: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/27199102/epidemiology-and-use-of-compression-treatment-in-venous-leg-ulcers-nationwide-claims-data-analysis-in-germany
#19
Kristina Heyer, Kerstin Protz, Gerd Glaeske, Matthias Augustin
Chronic venous diseases are the most common causes of leg ulcers. Compression treatment (CT) is a central component of venous leg ulcer (VLU) therapy along with prevention based on guidelines and clinical evidence. However, large-scale data on the use of CT are rare. In particular, there have not yet been published nationwide data for Germany. We analysed data from a large German statutory health insurance (SHI) on incident VLU between 2010 and 2012. VLUs were identified by ICD-10 diagnoses. The status of active disease was defined by wound-specific treatments...
May 19, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27146452/challenging-passivity-in-venous-leg-ulcer-care-the-abc-model-of-management
#20
Keith Harding
The under-utilisation of compression for venous leg ulcer (VLU) management translates into lost opportunities to heal wounds, improve patients' quality of life and maximise health care system efficiency. Although compression therapy is considered gold standard according to clinical guidelines, lack of clinician knowledge, unclear referral pathways, local unavailability of compression and patient unwillingness to receive compression, amongst other reasons, mean many candidates for compression do not receive appropriate treatment...
December 2016: International Wound Journal
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