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Venous leg ulcer

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https://www.readbyqxmd.com/read/29675338/assessing-the-healing-of-venous-leg-ulcers-using-a-noncontact-near-infrared-optical-imaging-approach
#1
Jiali Lei, Suset Rodriguez, Maanasa Jayachandran, Elizabeth Solis, Katrina Epnere, Francisco Perez-Clavijo, Stephen Wigley, Anuradha Godavarty
Objective: Venous leg ulcers (VLUs) are one of the most common complications in lower extremity wounds. To date, clinicians employ visual inspection of the wound site during its healing process by monitoring surface granulation and reduction in wound size across weeks of treatment. In this study, a handheld near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory to differentiate healing from nonhealing VLUs based on differences in blood flow to the wound and its surroundings...
April 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29660929/ecchymosis-a-novel-sign-in-patients-with-varicose-veins
#2
Ertan Yetkin, Mehmet Ileri, Johannes Waltenberger
BACKGROUND: In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein. MATERIALS AND METHODS: Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29660917/medical-compression-stockings-reduce-hypertension-of-nailfold-capillaries-at-the-toe-of-patients-with-chronic-venous-insufficiency1
#3
Anja Oelert, Manuela Kittel, Martin Hahn, Hermann Haase, Michael Jünger
In five patients who suffered from chronic venous insufficiency clinical stage C4 (n = 3) and C6 (n = 2) the capillary blood pressure was measured twice by means of invasive direct cannulation of nailfold capillaries of the toe. During one measurement course the patients wore below knee medical compression stockings (40 mmHg) during the other they did not have compression therapy. With the patient in supine position, the CP was investigated by the servo-nulling technique under resting conditions and under dynamic conditions: the calf-muscle/ankle joint venous pump was simulated by means of inflating a blood pressure cuff, which surrounded the mid lower leg, to 60 mmHg for 60 s...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29644145/publicly-reported-wound-healing-rates-the-fantasy-and-the-reality
#4
REVIEW
Caroline E Fife, Kristen A Eckert, Marissa J Carter
Significance: We compare real-world data from the U.S. Wound Registry (USWR) with randomized controlled trials and publicly reported wound outcomes and develop criteria for honest reporting of wound outcomes, a requirement of the new Quality Payment Program (QPP). Recent Advances: Because no method has existed by which wounds could be stratified according to their likelihood of healing among real-world patients, practitioners have reported fantastically high healing rates. The USWR has developed several risk-stratified wound healing quality measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of its Qualified Clinical Data Registry (QCDR)...
March 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29644144/comparative-effectiveness-of-a-bioengineered-living-cellular-construct-and-cryopreserved-cadaveric-skin-allograft-for-the-treatment-of-venous-leg-ulcers-in-a-real-world-setting
#5
Terry Treadwell, Michael L Sabolinski, Michelle Skornicki, Nathan B Parsons
Objective: A variety of advanced biological therapies are available for the treatment of chronic wounds such as venous leg ulcers (VLUs), but real-world comparative effectiveness data that can help guide decisions around treatments are currently lacking. Approach: This analysis was designed to compare the effectiveness of a bioengineered living cellular construct (BLCC) to a cryopreserved cadaveric skin allograft (CCSA) for the treatment of VLUs. Treatment records were collected from a large wound care-specific electronic medical record database on 717 patients (799 VLUs) receiving treatment at 177 wound care centers...
March 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29607227/rivaroxaban-treatment-for-warfarin-refractory-thrombosis-in-a-patient-with-hereditary-protein-s-deficiency
#6
Koken Ameku, Mariko Higa
Protein S (PS) deficiency, an autosomal dominant hereditary thrombophilia, is more prevalent in East Asian populations than in Caucasians. PS-deficient patients have historically been administered a heparin product followed by warfarin for the treatment and secondary prevention of venous thromboembolism (VTE). However, warfarin can be ineffective or causes detrimental effects in rare cases. While direct oral anticoagulants (DOACs) are being increasingly used for the treatment and prevention of VTE, their efficacy in PS-deficient patients has not been established...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29601617/collagen-powder-in-wound-healing
#7
Penelope J Kallis, Adam J Friedman
Chronic wounds, such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers, are associated with high costs, poor quality of life, and significant morbidity and mortality. A chronic wound develops when progression through the normal phases of wound healing goes awry, creating a hostile environment with elevated levels of pro-inflammatory cytokines, increased matrix metalloproteinases (MMPs), destruction of extracellular matrix (ECM) components, and diminished activity of growth factors and other soluble mediators...
April 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29600821/an-unusual-presentation-of-a-common-condition-allergic-contact-dermatitis
#8
Annie Price, Natalie M Stone, Keith G Harding
Allergic contact dermatitis commonly affects patients with chronic venous leg ulcers and can contribute to impaired wound healing. Many allergens have been identified, and despite the use of advanced dressings, the incidence of allergy has remained high. We discuss an unusual presentation of allergic contact dermatitis in a patient with a chronic wound. The patient's history was consistent with a recurrent venous leg ulcer, but on this occasion, the wound continued to deteriorate despite optimal treatment. This prompted further investigation, which included patch testing...
March 30, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29600560/contact-sensitivity-in-patients-with-venous-leg-ulcer-a-multi-centric-indian-study
#9
Reena Rai, Manjunath M Shenoy, Vishalakshi Viswanath, Nilendu Sarma, Imran Majid, Sunil Dogra
Venous leg ulcers are the most common form of non-healing leg ulcers. They are subjected to treatments such as topical medications, dressings, and compression therapies. This can lead to exposure to a number of allergens with subsequent sensitisation and contact dermatitis of the regional skin. This may contribute to the poor ulcer healing. To detect the various contact sensitisers in patients with venous leg ulcers through patch testing, patients from 6 centres across India with venous leg ulcers of longer than 6 weeks duration were enrolled for the study...
March 30, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29593807/enhanced-healing-and-anti-inflammatory-effects-of-a-carbohydrate-polymer-with-zinc-oxide-in-patients-with-chronic-venous-leg-ulcers-preliminary-results
#10
Mario Adan Moreno-Eutimio, Lorena Espinosa-Monroy, Tania Orozco-Amaro, Yessica Torres-Ramos, Araceli Montoya-Estrada, Juan Jose Hicks, Ernesto Rodríguez-Ayala, Pamela Del Moral, Jose Moreno, Jorge Cueto-García
Introduction: Insufficient wound healing related to chronic inflammation of chronic venous leg ulcers (CVUs) represents an important public health problem. The aim of this study was to evaluate the effects of a carbohydrate polymer with zinc oxide therapy on CVUs. Material and methods: Forty patients with CVUs were recruited for this study and were divided into a study group and control group. Patients In the study group were instructed to use venous compression treatment andtopical carbohydrate polymer with zinc oxide twice daily, while patients In the control group were treated with only venous compression treatment...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29584608/utilization-of-a-viable-human-amnion-membrane-allograft-in-elderly-patients-with-chronic-lower-extremity-wounds-of-various-etiologies
#11
Matthew Regulski
ntroduction. Chronic nonhealing wounds are a growing health care problem in the United States, afflicting more than 6.5 million patients annually. In particular, diseases that compromise skin integrity and impair normal wound healing processes, such as diabetes and peripheral vascular diseases, are becoming more common in the aging population and leading to ever-increasing incidence of these chronic nonhealing wounds. OBJECTIVE: The aim of this study is to evaluate a viable human amnion membrane allograft (vHAMA) for the treatment of chronic nonhealing wounds in elderly patients (aged > 65 years) with multiple comorbidities...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29584602/effect-of-a-new-purified-collagen-matrix-with-polyhexamethylene-biguanide-on-recalcitrant-wounds-of-various-etiologies-a-case-series
#12
Dimitrios Lintzeris, Karen Vernon, Heather Percise, Andy Strickland, Kari Yarrow, Amber White, Mary Gurganus, Susan Sherrod, Kathleen Vergin, Laura Johnson
INTRODUCTION: The management of chronic, nonhealing wounds in patients with multiple comorbidities continues to be a challenge for health care practitioners. Chronic wounds typically do not progress through the normal phases of wound healing and generally remain stagnant during the inflammatory phase, resulting in an increase in proteolytic enzymes with degradation of the extracellular matrix. Bacterial biofilm has been documented to be one of the main factors delaying wound healing, resulting in the prolongation of the inflammatory phase...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29584601/application-of-viable-cryopreserved-human-placental-membrane-grafts-in-the-treatment-of-wounds-of-diverse-etiologies-a-case-series
#13
Derek S Anselmo, James B McGuire, Ebony Love, Tracey Vlahovic
There is evidence in the literature that viable cryopreserved human placental membrane (vCHPM) grafts are effective in treating diabetic foot ulcers and venous leg ulcers. OBJECTIVE: This case series presents 3 cases of chronic ulcerations - 1 arterial ulcer (AU), 1 pressure ulcer (PU), and 1 recurrence of a pyoderma gangrenosum ulcer (PGU) - that had failed previous courses of standard wound care and were subsequently treated with vCHPM to determine if the treatment is an effective modality for treating wounds of these etiologies...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29572395/opportunities-for-better-value-wound-care-a-multiservice-cross-sectional-survey-of-complex-wounds-and-their-care-in-a-uk-community-population
#14
Trish A Gray, Sarah Rhodes, Ross A Atkinson, Katy Rothwell, Paul Wilson, Jo C Dumville, Nicky A Cullum
BACKGROUND: Complex wounds impose a substantial health economic burden worldwide. As wound care is managed across multiple settings by a range of healthcare professionals with varying levels of expertise, the actual care delivered can vary considerably and result in the underuse of evidence-based interventions, the overuse of interventions supported by limited evidence and low value healthcare. OBJECTIVES: To quantify the number, type and management of complex wounds being treated over a two-week period and to explore variations in care by comparing current practices in wound assessment, prevention and treatment...
March 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29550177/outcomes-of-endovascular-reconstruction-of-the-inferior-vena-cava-with-self-expanding-nitinol-stents
#15
Tim Sebastian, Jörn F Dopheide, Rolf P Engelberger, David Spirk, Nils Kucher
BACKGROUND: Occlusion of the inferior vena cava (IVC) often causes venous claudication, leg swelling, or skin changes. We hypothesized that the outcome of nitinol stents for endovascular reconstruction of the IVC is similar to the outcome reported for steel alloy stents. METHODS: From the prospective Bern Venous Stent Registry, we investigated technical success, patency rates, and clinical outcome in consecutive patients with endovascular IVC reconstruction. During routine follow-up visits, stent patency was assessed by duplex ultrasound...
March 14, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29545429/methacrylate-dressing-on-refractory-venous-leg-ulcers
#16
Rafael García Carretero, Maria Garrido-Ollero, Ana Martinez-Alvarez, Ana Cadenas-Vara
Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29536629/predicting-the-likelihood-of-venous-leg-ulcer-recurrence-the-diagnostic-accuracy-of-a-newly-developed-risk-assessment-tool
#17
Kathleen J Finlayson, Christina N Parker, Charne Miller, Michelle Gibb, Suzanne Kapp, Rajna Ogrin, Jacinta Anderson, Kerrie Coleman, Dianne Smith, Helen E Edwards
The aim of this study was to validate a newly developed tool for predicting the risk of recurrence within 12 months of a venous leg ulcer healing. Performance of the tool to predict recurrence within a 12-month period was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Multi-site retrospective and prospective longitudinal studies were undertaken to validate a risk assessment tool for the recurrence of venous leg ulcers within 12 months. In the retrospective study (n = 250), 55% of venous leg ulcers recurred within 12 months, and the risk assessment total score had excellent discrimination and goodness of fit with an AUC of 0...
March 13, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29525414/outcomes-of-reintervention-for-recurrent-symptomatic-disease-after-tibial-endovascular-intervention
#18
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
OBJECTIVE: Tibial interventions for critical limb ischemia are now commonplace. Restenosis and occlusion remain barriers to durability after intervention. The aim of this study was to examine the patient-centered outcomes of open and endovascular reintervention for symptomatic recurrent disease after a primary isolated tibial endovascular intervention. METHODS: A database of patients undergoing isolated primary lower extremity tibial endovascular interventions between 2006 and 2016 was retrospectively queried...
March 8, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29513326/ftir-spectroscopy-of-chronic-venous-leg-ulcer-exudates-an-approach-to-spectral-healing-marker-identification
#19
Nicolas Cerusico, Juan P Aybar, Silvana Lopez, Silvia G Molina, Romina Chavez Jara, Maria Eugenia Sesto Cabral, Juan C Valdez, Aida Ben Altabef, Alberto N Ramos
Chronic venous leg ulcer (CVLU) arises as a chronic venous insufficiency complication and is a major cause of morbidity throughout the world. Our hypothesis is that the CVLU exudate composition is a biochemical representation of the wound clinical state. Then, Fourier Transform Infrared (FTIR) spectroscopy could be a useful and less-invasive technique to study the clinical state of the ulcer. For this, the aim of this work was to perform a spectral characterization of the exudate from CVLU using FTIR spectroscopy to identify potential healing markers...
March 7, 2018: Analyst
https://www.readbyqxmd.com/read/29509113/a-cost-effectiveness-analysis-of-a-hydration-response-technology-dressing-in-the-treatment-of-venous-leg-ulcers-in-the-uk
#20
Stefan Walzer, Daniel Dröschel, Lutz Vollmer, Leanne Atkin, Karen Ousey
OBJECTIVE: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 16-24 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care...
March 2, 2018: Journal of Wound Care
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