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Venous leg ulcer

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https://www.readbyqxmd.com/read/29452957/a-systematic-review-of-the-efficacy-and-limitations-of-venous-intervention-in-stasis-ulceration
#1
REVIEW
Myriam L Montminy, Arjun Jayaraj, Seshadri Raju
BACKGROUND: Surgical techniques to address various components of chronic venous disease are rapidly evolving. Their efficacy and generally good results in treating superficial venous reflux (SVR) have been documented and compared in patients presenting with pain and swelling. A growing amount of literature is now available suggesting their efficacy in patients with venous leg ulcer (VLU). This review attempts to summarize the efficacy and limitations of commonly used venous interventions in the treatment of SVR and incompetent perforator veins (IPVs) in patients with VLU...
February 13, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29452627/case-series-of-18-patients-with-lower-extremity-wounds-treated-with-a-concentrated-surfactant-based-gel-dressing
#2
Catherine R Ratliff
The purpose of this case series was to assess the performance of a concentrated surfactant-based gel (CSG) dressing on 18 patients in the outpatient setting over 4 weeks. Wounds selected were full thickness, had been presented for greater than 4 weeks, and were located on the lower extremities. Patients were given the CSG dressing and instructed on its use. On follow-up clinic visits, the wound was assessed, measurements were obtained, Pressure Ulcer Scale for Healing (PUSH) Tool scores completed, and satisfaction with the dressing was solicited...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29446252/what-is-the-effect-of-exercise-on-wound-healing-in-patients-with-venous-leg-ulcers-a-systematic-review
#3
Daisy Smith, Rebecca Lane, Rosemary McGinnes, Jane O'Brien, Renea Johnston, Lyndal Bugeja, Victoria Team, Carolina Weller
Standard best practice for the treatment of venous leg ulcers (VLUs) is compression bandaging of the lower leg to reduce hydrostatic pressure. There is considerable variation in reported healing rates when using this gold-standard approach; therefore, a systematic and robust evaluation of other interventions is required. Exercise interventions, in addition to standard compression therapy, could improve wound-healing time and prevent their recurrence. We have conducted a systematic review to examine the effects of exercise on wound characteristics, including time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes...
February 15, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29440219/wool-derived-keratin-dressings-versus-usual-care-dressings-for-treatment-of-slow-healing-venous-leg-ulceration-study-protocol-for-a-randomised-controlled-trial-keratin4vlu
#4
Andrew Jull, Angela Wadham, Chris Bullen, Varsha Parag, Jill Waters
INTRODUCTION: Keratins, filament-forming proteins found in vertebrate epithelium, are downregulated in slow-healing venous leg ulcers (VLU) compared with normal-healing VLU. Laboratory and animal model research has suggested exogenous keratins increase expression of endogenous keratins. A non-randomised controlled trial of an exogenous keratin dressing reported increased healing in slow-healing VLU. To date, no randomised controlled trial has been done to verify these promising findings...
February 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29438147/ulcerated-basal-cell-carcinomas-masquerading-as-venous-leg-ulcers
#5
Catherine N Tchanque-Fossuo, Jillian W Millsop, Mary Ann Johnson, Sara E Dahle, R Rivkah Isseroff
BACKGROUND: Nonmelanoma skin cancers rarely arise from venous leg ulcers (VLUs). Although basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer, its association with lower-extremity ulcers is not as frequently reported as other malignancies. OBJECTIVE: To report a case series of biopsy-proven BCC from lower-extremity ulcers of patients who presented at a multispecialty wound clinic. METHODS: Four male patients (mean age, 82...
March 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29424645/micrografting-chronic-lower-extremity-ulcers-with-mechanically-disaggregated-skin-using-a-micrograft-preparation-system
#6
Rosario Miranda, Eleonora Farina, Michele A Farina
OBJECTIVE: The Rigenera system is a new standardised micrograft preparation system. It works by means of automated mechanical disaggregation of small tissue samples, extracting only the smallest cells (<50µm). The aim of this study was to retrospectively evaluate patients affected by chronic ulcers and who were treated with the micrograft preparation method. METHOD: Chronic ulcers have been included regardless of the cause. The specimen was collected with a 3mm diameter biopsy punch and immediately dissociated by means of the Rigenera System...
February 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29424641/cost-effectiveness-of-using-a-collagen-containing-dressing-plus-compression-therapy-in-non-healing-venous-leg-ulcers
#7
Julian F Guest, Karan Rana, Heenal Singh, Peter Vowden
OBJECTIVE: To estimate whether collagen-containing dressings could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of non-healing venous leg ulcers (VLUs). METHOD: This was a modelling study performed from the perspective of the UK's NHS. A combination of published clinical outcomes, resource utilisation estimates and utilities for VLUs enabled the construction of a decision model, depicting the management of a chronic VLU with standard care or with a collagen-containing dressing plus compression therapy followed by standard care, over a period of 6 months...
February 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29424318/the-significance-of-pain-in-chronic-venous-disease-and-its-medical-treatment
#8
Djordje Radak, Igor Atanasijevic, Mihailo Neskovic, Esma Isenovic
Chronic venous disease (CVeD) is a highly prevalent condition in the general population, and it has a significant impact on quality of life. While it is usually manifested by obvious signs, such as varicose veins and venous ulcers, other symptoms of the disease are less specific. Among the other symptoms, which include heaviness, swelling, muscle cramps and restless legs, pain is the symptom that most frequently compels CVeD patients to seek medical aid. However, there is a substantial discrepancy between pain severity and clinically detectable signs of CVeD, questioned by several opposing studies...
February 8, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29399261/hyaluronic-acid-sodium-salt-0-2-gel-in-the-treatment-of-a-recalcitrant-distal-leg-ulcer-a-case-report
#9
Mario Tagliagambe, Tuan A Elstrom, Daniel B Ward
Venous leg ulcers can lead to debilitation and a decrease in quality of life and can require costly treatments. Compression therapy remains the foundation of conservative treatment. However, some ulcers become indolent, chronic, and unresolved for years, even with adherence to standard of care. Here, the authors describe the case of a 56-year-old male patient with a recalcitrant recurrent distal leg ulcer. The ulcer was treated initially with debridement and compression therapy, respectively, and then subsequently with hyaluronic acid sodium salt 0...
November 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/29388188/the-paracelsus-score-a-novel-diagnostic-tool-for-pyoderma-gangrenosum
#10
F Jockenhöfer, U Wollina, K A Salva, S Benson, J Dissemond
BACKGROUND: The lack of objective diagnostic criteria renders pyoderma gangrenosum (PG) a diagnosis of exclusion. The diagnostic approaches proposed to date have not been systematically evaluated. Thus, PG remains a challenging and frequently misdiagnosed disorder. OBJECTIVES: To develop and assess a comprehensive yet clinically practicable as well as sensitive diagnostic scoring system for PG. METHODS: Clinical history and images of a total of 60 subjects with previously confirmed PG located on the lower extremity as well as a control cohort of 50 patients with venous leg ulcers were retrospectively evaluated by expert teams at two tertiary dermatological centres specializing in wound care using a newly developed diagnostic scoring system composed of ten criteria...
February 1, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29378357/predictors-of-post-thrombotic-ulcer-after-acute-dvt-the-riete-registry
#11
Jean-Philippe Galanaud, Laurent Bertoletti, Maria Amitrano, Carmen Fernández-Capitán, José María Pedrajas, Vladimir Rosa, Manuel Barrón, Alicia Lorenzo, Olga Madridano, Isabelle Quéré, Susan R Kahn, Paolo Prandoni, Manuel Monreal
In patients with deep-vein thrombosis (DVT) in the lower limbs, venous ulcer is the most debilitating and end-stage clinical expression of the post-thrombotic syndrome (PTS). To date, risk factors for PTS-related ulcer in DVT patients have not been identified.We used the international observational RIETE registry to assess the evolution of PTS signs and symptoms during a 3-year follow-up period and to identify independent predictors of PTS ulcer at 1 year in patients with acute DVT.Among 1,866 eligible patients, cumulative rates of PTS ulcer at 1, 2 and 3 years were 2...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29368880/the-influence-of-exercise-on-ulcer-healing-in-patients-with-chronic-venous-insufficiency
#12
Omar Mutlak, Mohammed Aslam, Nigel Standfield
BACKGROUND: Venous Leg Ulcer (VLU) affects millions of people, and yet there have been no major advances in its treatment for many decades. Is it the time to change our approach, and try a multidisciplinary one that could bring about a change. The aim of this study is to evaluate whether a regular, home-based exercise could be influential in healing the VLU. METHODS: 80 subjects (mean age: 65.13 years) were recruited for 12 weeks. The participants were randomised into a control group (n=20), a compression therapy group (n=20), an exercise group (n=20) and a compression and exercise group (n=20)...
January 25, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29350654/autolytic-debridement-and-management-of-bacterial-load-with-an-occlusive-hydroactive-deressing-impregnated-with-polyhexamethylene-biguanide
#13
Stefano Mancini, Roberto Cuomo, Mauro Poggialini, Carlo D'Aniello, Giuseppe Botta
BACKGROUND: Debridement and control of bacterial load are key-points of wound care. The aim of this study is to evaluate the effectiveness of autolytic debridement and management of bacterial load (bioburden) of an occlusive hydro-active dressing impregnated with polyhexamethylene biguanide (PHMB). METHODS: We used an occlusive dressing of hydro-active for leg ulcers' treatment (TenderWet-plus® - Hartmann).  Inclusion criteria were: presence of a fibrinous ulcer with multiple etiopathogenesis, in absence of clinical infection, no hypersecretion and diameter within 5 cm...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29334174/trichloroacetic-acid-80-as-a-chemical-debridement-method-for-chronic-venous-leg-ulcers-a-pilot-study
#14
Rita R Pinheiro, Bruno Duarte, Joana Cabete
Debridement is essential for the optimal care of venous leg ulcers. Several debridement methods with different limitations may be deployed. Trichloroacetic acid (TCA) is used for several dermatological purposes. Its application as a chemical debridement method for leg ulcers has never been explored. We designed a prospective study to determine the role of 80% TCA solution as a chemical debridement method for leg ulcers, regarding efficacy and procedure-associated pain. Chronic venous leg ulcers were treated with 3 cycles of 80% TCA solution or curettage over 1 week...
January 15, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29334016/case-report-to-demonstrate-the-need-for-selection-criteria-for-optimal-adjustable-velcro-wrap-prescription
#15
Suzie Ehmann, Karen Bock
Compression, in the form of either a compression bandage or a compression stocking, has been touted as the gold standard for treatment of swelling and venous leg ulcers (VLUs). Adjustable Velcro wraps have been marketed as compression alternative. Although there is a growing body of evidence to support use of these products, there has not been a critical evaluation of the functionality of the devices to best matching product to patient presentation and ability to use the device effectively. Unlike compression garments, which are classified by compression category (class I/II or flat knit/circular), there is not an algorithm to direct health professionals to best match a specific adjustable Velcro wrap to an individual patient presentation...
January 1, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29326878/ten-year-long-enzyme-replacement-therapy-shows-a-poor-effect-in-alleviating-giant-leg-ulcers-in-a-male-with-fabry-disease
#16
Jun Okada, Mohammad Arif Hossain, Chen Wu, Takashi Miyajima, Hiroko Yanagisawa, Keiko Akiyama, Yoshikatsu Eto
Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of α-galactosidase A (α-gal A), leading to the progressive accumulation of glycosphingolipids. Classical hemizygous males usually present symptoms, including pain and paresthesia in the extremities, angiokeratoma, hypo- or anhidrosis, abdominal pain, cornea verticillata, early stroke, tinnitus, and/or hearing loss, during early childhood or adolescence. Moreover, proteinuria, renal impairment, and cardiac hypertrophy can appear with age...
March 2018: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/29277969/predicting-delayed-healing-the-diagnostic-accuracy-of-a-venous-leg-ulcer-risk-assessment-tool
#17
Helen E Edwards, Christina N Parker, Charne Miller, Michelle Gibb, Suzanne Kapp, Rajna Ogrin, Jacinta Anderson, Kerrie Coleman, Dianne Smith, Kathleen J Finlayson
The aim of this study was to validate a newly developed tool that can predict the risk of failure to heal of a venous leg ulcer in 24 weeks. The risk assessment tool was validated, and performance of the tool was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Retrospective and prospective validation was conducted through multi-site, longitudinal studies. In the retrospective study (n = 318), 30% of ulcers did not heal within 24 weeks, with the tool demonstrating an AUC of 0...
December 26, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29277134/customizing-elastic-pressure-bandages-for-reuse-to-a-predetermined-sub-bandage-pressure-a-randomized-controlled-trial
#18
Nuttawut Sermsathanasawadi, Tanakorn Tarapongpun, Rattana Pianchareonsin, Nattawut Puangpunngam, Chumpol Wongwanit, Khamin Chinsakchai, Pramook Mutirangura, Chanean Ruangsetakit
Objective A randomized clinical trial was performed to compare the effectiveness of unmarked bandages and customized bandages with visual markers in reproducing the desired sub-bandage pressure during self-bandaging by patients. Method Ninety patients were randomly allocated to two groups ("customized bandages" and "unmarked bandages") and asked to perform self-bandaging three times. The achievement of a pressure between 35 and 45 mmHg in at least two of the three attempts was defined as adequate quality...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/29276458/association-of-venous-leg-ulcers-with-ankle-range-of-motion-in-people-attending-chiropractic-mobile-clinics-in-the-dominican-republic
#19
Patricia A Tavares, Victoria Landsman, Nathalie Gomez, Ariel Ferreiras, Ramon A Lopez
Objective: The goal of the study was to determine if there was an association between chronic venous disorders (CVDs), particularly venous leg ulcers, and ankle range of motion (ROM) in the Dominican Republic. Methods: Chronic venous disorders were classified using the clinical manifestations portion (C) of the CEAP (clinical manifestations, etiology, anatomy, pathophysiology) method. The legs of participants attending mobile chiropractic clinics in rural, low-income areas in the Dominican Republic were assessed for clinical signs of CVD and venous ulcers...
December 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29248102/the-center-for-vein-restoration-study-on-presenting-symptoms-treatment-modalities-and-outcomes-in-medicare-eligible-patients-with-chronic-venous-disorders
#20
Peter J Pappas, Sanjiv Lakhanpal, Khanh Q Nguyen, Rohan Vanjara
BACKGROUND: Chronic venous disorders (CVDs) have been estimated to affect up to 20 million Americans. Despite this huge prevalence, the signs, symptoms, and treatment outcomes in patients 65 years of age and older are not well defined. Our goal was to determine the presentation and treatment outcomes in elderly patients compared with a cohort of patients younger than 65 years. METHODS: From January 2015 to December 2016, we retrospectively reviewed prospectively collected data from 38,750 patients with CVD from the Center for Vein Restoration's electronic medical record (NextGen Healthcare Information Systems, Irvine, Calif)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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