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Chronic leg ulcers

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https://www.readbyqxmd.com/read/28092206/impact-of-uk-nice-clinical-guidelines-168-on-referrals-to-a-specialist-academic-leg-ulcer-service
#1
Huw Ob Davies, Matthew Popplewell, Gareth Bate, Lisa Kelly, Katy Darvall, Andrew W Bradbury
Background Leg ulcers are a common cause of morbidity and disability and result in significant health and social care expenditure. The UK National Institute for Health and Care Excellence (NICE) Clinical Guideline (CG)168, published in July 2013, sought to improve care of patients with leg ulcers, recommending that patients with a break in the skin below the knee that had not healed within two weeks be referred to a specialist vascular service for diagnosis and management. Aim Determine the impact of CG168 on referrals to a leg ulcer service...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28088662/metabolic-profiles-of-exudates-from-chronic-leg-ulcerations
#2
Adam Junka, Wojciech Wojtowicz, Adam Ząbek, Grzegorz Krasowski, Danuta Smutnicka, Barbara Bakalorz, Agnieszka Boruta, Mariusz Dziadas, Piotr Młynarz, Parish Paymon Sedghizadeh, Marzenna Bartoszewicz
Chronic leg ulceration is a disease usually associated with other comorbidities, and significantly reduces patient quality of life. Infected leg ulcers can lead to limb-threatening sequelae or mortality. Leg ulcerations are colonized by a number of microbes that are able to cause life-threating infections in susceptible patients. Wound exudate is a body fluid that collects metabolites from patient eukaryotic cells and from prokaryotic bacterial communities inhabiting the wound. This study aimed at identification of metabolites in exudates collected from chronic leg ulcers, and correlation of this metabolome with patient comorbidities and microbiological status of the wound...
January 10, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28077026/a-case-control-study-of-risk-factors-of-chronic-venous-ulceration-in-patients-with-varicose-veins
#3
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/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/28032340/the-burden-of-common-skin-diseases-assessed-with-the-eq5d-a-european-multi-centre-study-in-13-countries
#5
F Balieva, J Kupfer, L Lien, U Gieler, A Y Finlay, L Tomas-Aragonés, F Poot, L Misery, F Sampogna, H van Middendorp, J A Halvorsen, J C Szepietowski, A Lvov, S E Marrón, M S Salek, F J Dalgard
BACKGROUND: Generic instruments measuring health related quality of life (HRQoL), like EQ5D, enable comparison of skin diseases with healthy populations and non-dermatological medical conditions, as well as calculation of utility data. OBJECTIVES: The aims were to measure HRQoL in patients with common skin diseases and healthy controls across Europe using the EQ5D. METHODS: This multi-center observational cross-sectional study was conducted in 13 European countries...
December 29, 2016: British Journal of Dermatology
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
#6
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/27992062/leg-ulcers-in-sickle-cell-disease-factors-predictive-of-healing-a-multicenter-prospective-cohort-study
#7
P Senet, C Blas-Chatelain, P Levy, E M Manea, M Peschanski, T Mirault, K Stankovic-Stojanovic, C Debure, K Debbache, R Girot, J-M Bureau, C Bachmeyer, C Baldeschi, F Galacteros, F Lionnet, J Gellen-Dautremer
BACKGROUND: Leg ulcers (LUs) are a chronic and severe complication of sickle-cell disease (SCD). A prospective study identifying SCD patients' factors associated with LU complete healing and recurrence is lacking. OBJECTIVES: To determine clinical and biological factors associated with SCD-LU complete healing and recurrence. METHODS: This prospective, observational cohort study conducted at two Adult SCD Referral Center sites (2009-2015), included 98 consecutive patients with ≥ 1 LU(s) lasting ≥ 2 weeks...
December 19, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27987244/aspirin-treatment-for-chronic-wounds-potential-beneficial-and-inhibitory-effects
#8
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/27974007/impact-of-optimal-anticoagulation-therapy-on-chronic-venous-ulcer-healing-in-thrombophilic-patients-with-post-thrombotic-syndrome
#9
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
#10
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/27917617/chronic-oedema-a-prevalent-health-care-problem-for-uk-health-services
#11
Christine J Moffatt, Vaughan Keeley, Peter J Franks, Anna Rich, Lorraine L Pinnington
Chronic oedema (CO) is a major clinical problem worldwide, which has many important secondary consequences for health, activity and participation. Effective treatment planning and organisation of services is dependent on an understanding of the condition and its epidemiology. This cross-sectional study was designed to estimate the point prevalence of CO within the health services of one UK urban population and to determine the proportions that have concurrent leg ulceration. Patients with CO in all anatomic sites were ascertained by health care professionals in one acute and one community hospital, all relevant outpatient and community nursing services, general practices and all nursing/residential homes in one urban catchment area (Derby City)...
December 4, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27914110/physical-exercise-for-the-treatment-of-non-ulcerated-chronic-venous-insufficiency
#12
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
https://www.readbyqxmd.com/read/27905181/effectiveness-of-collagen-oxidised-regenerated-cellulose-silver-containing-composite-wound-dressing-for-the-treatment-of-medium-depth-split-thickness-skin-graft-donor-site-wounds-in-multi-morbid-patients-a-prospective-non-comparative-single-centre-study
#13
Alexander Konstantinow, Tatjana V Fischer, Johannes Ring
Split-thickness skin grafting (STSG) is a widely used method in reconstructive surgery, but donor site wounds (DSWs) are often slow healing and painful. This prospective study evaluated the performance of a composite wound dressing containing collagen/oxidised regenerated cellulose in the treatment of medium-depth (0·4 mm) DSWs in 25 multi-morbid patients with chronic leg ulcers requiring STSG. The range of patients' ages was 44-84 years (mean 71·6 years) with DSW sizes ranging between 12 and 162 cm(2) (mean 78 cm(2) )...
December 1, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27886005/compression-in-the-treatment-of-chronic-venous-insufficiency-efficacy-depending-on-the-length-of-the-stocking
#14
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
#15
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
#16
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/27864837/risk-factors-for-non-purulent-leg-cellulitis-a-systematic-review-and-meta-analysis
#17
REVIEW
M Quirke, F Ayoub, A McCabe, F Boland, B Smith, R O'Sullivan, A Wakai
Non-purulent cellulitis is an acute bacterial infection of the dermal and subdermal tissues that is not associated with purulent drainage, discharge or abscess. The objective of this systematic review and meta-analysis (SRMA) was to identify and appraise all controlled observational studies that have examined risk factors for the development of non-purulent cellulitis of the leg (NPLC). A systematic literature search of electronic databases and grey literature sources was performed in July 2015. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality of included studies...
November 18, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27849283/social-repercussions-experienced-by-elderly-with-venous-ulcer
#18
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/27843012/-erratum-to-when-to-worry-about-before-a-vascular-chronic-leg-ulcer-j-mal-vasc-41-2016-307-314
#19
I Lazareth
No abstract text is available yet for this article.
December 2016: Journal des Maladies Vasculaires
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
#20
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
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