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Chronic leg ulcers

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https://www.readbyqxmd.com/read/28810449/the-importance-of-relationships-in-treatment-for-chronic-leg-ulceration
#1
Philippa Tollow, Jane Ogden
Leg ulcers are a hard-to-heal wound that can have a profound impact on the lives of those that they affect. While a significant body of evidence has explored the efficacy of various treatments for leg ulcers, little research has addressed the patient experience of such treatment. A total of 21 participants were recruited for this qualitative interview study, exploring patient's experiences of non-surgical treatment for leg ulcers. Thematic analysis identified two major themes, 'Failure' and 'Powerlessness', as well as the overarching theme of 'Relationships'...
May 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28798504/molecular-aspects-of-wound-healing-and-the-rise-of-venous-leg-ulceration-omics-approaches-to-enhance-knowledge-and-aid-diagnostic-discovery
#2
REVIEW
Daniel A Broszczak, Elizabeth R Sydes, Daniel Wallace, Tony J Parker
Chronic wounds, in particular venous leg ulcers (VLU), represent a substantial burden for economies, healthcare systems and societies worldwide. This burden is exacerbated by the recalcitrant nature of these wounds, despite best practice, evidence-based care, which substantially reduces the quality of life of patients. Furthermore, co-morbidities such as diabetes and cardiovascular disease within ageing populations further contribute to the increasing prevalence in developed countries. This review provides an overview of the literature concerning the cellular and molecular mechanisms of wound healing and aspects where this process fails, resulting in a chronic wound...
February 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28795238/efficacy-and-safety-of-sofosbuvir-based-interferon-free-therapy-the-management-of-rheumatologic-extrahepatic-manifestations-associated-with-chronic-hepatitis-c%C3%A2-virus-infection
#3
A A Shahin, H S Zayed, M Said, S A Amer
BACKGROUND: The use of pegylated interferon alpha (IFN) has been of concern in chronic hepatitis C virus (HCV) patients with rheumatologic extrahepatic manifestations (EHM) due to the immunostimulatory effects of IFN. AIM: To study the efficacy and safety of sofosbuvir-based, IFN-free antiviral therapy in chronic HCV patients with rheumatologic EHM. MATERIAL AND METHODS: Group A included 24 patients with arthropathy (arthralgia or arthritis, n = 15) or vasculitis (n = 9) who received sofosbuvir and ribavirin (n = 17) or sofosbuvir and simeprevir (n = 7)...
August 9, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28793373/reflection-on-the-cause-and-avoidance-of-recurrent-venous-leg-ulcers-an-interpretive-descriptive-approach
#4
Ann Stewart, Helen Edwards, Kathleen Finlayson
AIMS AND OBJECTIVES: To gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated. BACKGROUND: Venous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28759158/no-sting-barrier-film-to-protect-skin-in-adult-patients-findings-from-a-scoping-review-with-implications-for-evidence-based-practice
#5
Chiara Micheli, Alvisa Palese, Federica Canzan, Elisa Ambrosi
BACKGROUND: In the industrialized world, approximately 1-1.5% of the population has received treatments for skin lesions. In the 1990s, a polymeric barrier film called the No Sting Barrier Film (NSBF) was developed as an alternative to petrolatum-based ointments and zinc oxide formulas. To date, few studies have explored the effectiveness of NSBF in protecting skin integrity. AIMS: To map the methods, fields and outcomes used to produce evidence on NSBF effectiveness...
July 31, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28758717/epa%C3%A2-%C3%A2-dha-supplementation-reduces-pmn-activation-in-microenvironment-of-chronic-venous-leg-ulcers-a-randomized-double-blind-controlled-study
#6
Jodi C McDaniel, Laura Szalacha, Michelle Sales, Sashwati Roy, Scott Chafee, Narasimham Parinandi
Sustained high levels of activated polymorphonuclear leukocytes (PMNs) and PMN-derived proteases in the microenvironment of chronic venous leg ulcers (CVLUs) are linked to chronic inflammation and delayed healing. Uncontrolled PMN activity eventually destroys newly developed tissue and degrades critical growth factors. The bioactive components of fish oil (n-3 eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) have strong inflammation-resolving actions and have been shown to assuage PMN activity, but have not been tested in CVLU patients...
July 31, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28750144/therapy-of-ulcus-cruris-of-venous-and-mixed-venous-arterial-origin-with-autologous-adult-native-progenitor-cells-from-subcutaneous-adipose-tissue-a-prospective-clinical-pilot-study
#7
A Konstantinow, A Arnold, K Djabali, W Kempf, J Gutermuth, T Fischer, T Biedermann
BACKGROUND: The stromal vascular fraction (SVF) of adipose tissue consists of cellular subpopulations with distinct regenerative potential. OBJECTIVE: To investigate the regenerative capacities of autologous SVF cells in the treatment of chronic leg ulcers of venous (VLU) and arterial-venous (AVLU) origin. METHODS: Multimorbid ulcer patients received a singular topical treatment with 9-15x10(6) SVF cells, separated from abdominal lipoaspirates by digestion with collagenase and dispase and applied immediately after isolation...
July 27, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28730726/changes-in-the-extracellular-matrix-surrounding-human-chronic-wounds-revealed-by-2-photon-imaging
#8
Jessica E S Sutcliffe, Christopher Thrasivoulou, Thomas E Serena, Leigh Madden, Toby Richards, Anthony R J Phillips, David L Becker
Chronic wounds are a growing problem worldwide with no effective therapeutic treatments available. Our objective was to understand the composition of the dermal tissue surrounding venous leg ulcers and diabetic foot ulcers (DFU). We used novel 2-photon imaging techniques alongside classical histology to examine biopsies from the edges of two common types of chronic wound, venous leg ulcers and DFU. Compared to normal intact skin, we found that collagen levels are significantly reduced throughout the dermis of venous leg ulcer biopsies and DFU, with a reduction in both fibril thickness and abundance...
July 20, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28727591/the-effectiveness-of-emla-as-a-primary-dressing-on-painful-chronic-leg-ulcers-a-pilot-randomized-controlled-trial
#9
Anne Purcell, Thomas Buckley, Judith Fethney, Jennie King, Wendy Moyle, Andrea P Marshall
OBJECTIVE: To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers. DESIGN: A pilot randomized controlled trial. SETTING: The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia. PARTICIPANTS: Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study...
August 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28727481/leucocyte-and-platelet-rich-fibrin-l-prf-as-a-regenerative-medicine-strategy-for-the-treatment-of-refractory-leg-ulcers-a-prospective-cohort-study
#10
Nelson R Pinto, Matias Ubilla, Yelka Zamora, Verónica Del Rio, David M Dohan Ehrenfest, Marc Quirynen
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients...
July 20, 2017: Platelets
https://www.readbyqxmd.com/read/28712679/the-molecular-biology-in-wound-healing-non-healing-wound
#11
REVIEW
Chun Qing
The development of molecular biology and other new biotechnologies helps us to recognize the wound healing and non-healing wound of skin in the past 30 years. This review mainly focuses on the molecular biology of many cytokines (including growth factors) and other molecular factors such as extracellular matrix (ECM) on wound healing. The molecular biology in cell movement such as epidermal cells in wound healing was also discussed. Moreover many common chronic wounds such as pressure ulcers, leg ulcers, diabetic foot wounds, venous stasis ulcers, etc...
June 30, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28704156/quality-of-life-in-patients-with-leg-ulcers-results-from-challenge-a-double-blind-randomised-controlled-trial
#12
S Meaume, A Dompmartin, C Lok, I Lazareth, M Sigal, F Truchetet, A Sauvadet, S Bohbot
OBJECTIVE: We recently showed the superiority of a matrix metalloproteinase (MMP) modulating dressing (foam impregnated with NOSF, nano-oligosaccharide factor) compared with a lipidocolloid matrix (TLC) control dressing in median wound area reduction (WAR). Here we report the results from the same study assessing the performance and safety of TLC-NOSF in the local management of venous leg ulcers (VLUs) or mixed leg ulcers and determining its impact on the patient's health-related quality of life (HRQoL)...
July 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28702982/chronic-inflammation-therapy-combined-with-low-dose-cytokines-in-the-treatment-of-chronic-ulcers-of-lower-limbs
#13
S E Aragona, P Amori, G Mereghetti, J Lotti, T Lotti, G V L Colombo
Prevalence of chronic venous leg ulcers has increased from 55% to 75% in 10 years. We treat chronic vascular lesions according to a cyclic multiphase method that follows the instrumental and differential etiologic diagnosis of ulcers of the lower limbs. The AIMED (Anti Inflammatory Regenerative Medicine) operating model follows the diagnostic phase and is structured in 5 interconnected phases. Mare evaluation, pH control, biofilm removal and prevention and infections are approached according to the International Guidelines...
July 13, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28702902/oxygenation-status-in-chronic-leg-ulcer-after-topical-hemoglobin-application-may-act-as-a-surrogate-marker-to-find-the-best-treatment-strategy-and-to-avoid-ineffective-conservative-long-term-therapy
#14
Maximilian Petri, Ingo Stoffels, Klaus Griewank, Jithin Jose, Peter Engels, Andrea Schulz, Harald Pötzschke, Philipp Jansen, Dirk Schadendorf, Joachim Dissemond, Joachim Klode
PURPOSE: Chronic leg ulcers can be a challenge to treat and long-term therapy a significant cost factor in western public health budgets. Objective wound assessment assays enabling selection of appropriate wound therapy regimes would be desirable. Oxygenation status in ulcer tissue has obtained increased attention as a relevant factor in wound healing. To increase oxygenation in wounds, a topical hemoglobin spray was developed. Although favorable results have been noted, the link between clinical efficacy and the mode of action has not been demonstrated...
July 12, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28699283/prospective-evaluation-of-chronic-organ-damage-in-adult-sickle-cell-patients-a-seven-year-follow-up-study
#15
Charlotte F J van Tuijn, Marein Schimmel, Eduard J van Beers, Erfan Nur, Bart J Biemond
Organ damage in sickle cell disease (SCD) is a crucial determinant for disease severity and prognosis. In a previous study, we analyzed the prevalence of SCD-related organ damage and complications in adult sickle cell patients. We now describe a seven-year follow-up of this cohort.All patients from the primary analysis in 2006 (n = 104), were included for follow-up. Patients were screened for SCD-related organ damage and complications (microalbuminuria, renal failure, elevated tricuspid regurgitation flow velocity (TRV) (≥2...
July 11, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28682676/a-double-blind-placebo-controlled-randomized-evaluation-of-the-effect-of-low-level-laser-therapy-on-venous-leg-ulcers
#16
Julian Vitse, Farid Bekara, Stephanie Byun, Christian Herlin, Luc Teot
This study aimed to determine the effect of low-level laser therapy (LLLT) on chronic venous leg ulcers (VLUs). A double-blinded prospective randomized controlled trial was conducted to compare incidence of complete wound closure, ulcer size and pain reduction in patients randomized to 24 treatments of placebo or LLLT (635 nm) over 12 weeks. Patients presented with a 6-week history of VLUs ranging in size from 5 to 20 cm(2). Venous origin was confirmed by Doppler ultrasound and an ankle brachial index of 0...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28682672/sickle-cell-anemia-and-comorbid-leg-ulcer-treated-with-curative-peripheral-blood-stem-cell-transplantation
#17
Joseph L Connor, Caterina P Minniti, John F Tisdale, Matthew M Hsieh
Allogeneic bone marrow transplantation or peripheral blood stem cell transplantation (PBSCT) are the only curative therapies for patients with sickle cell disease (SCD). Once the patients have successfully undergone transplantation and engrafted, the hallmark of hemolytic anemia resolves, and normal hemoglobin levels are achieved. Some transplant protocols exclude patients with open wounds, including leg ulcers, because of infection risks associated with transplantation and long-term immunosuppression required to prevent graft-versus-host disease...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28681136/-german-national-consensus-on-wound-documentation-of-leg-ulcer-part%C3%A2-2-routine-care-classification-of-variable-characteristics
#18
REVIEW
K Herberger, K Heyer, K Protz, A Mayer, J Dissemond, S Debus, T Wild, J Schmitt, M Augustin
BACKGROUND: Standards in the assessment and documentation of disease processes are the basis of guideline-based care. For the treatment of chronic wounds, especially leg ulcers, no approved parameters are available. OBJECTIVES: Against this background, our aim was to develop standards for the documentation of leg ulcer in routine care. This article presents the recommendations for the classification and characteristics of the variables. MATERIALS AND METHODS: The development of the documentation standard was based on a systematic literature research and was performed in a Delphi-based consensus process...
July 5, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28674266/pilot-cohort-study-assessing-the-efficacy-of-endovascular-revascularization-in-the-restoration-of-peripheral-sensory-disturbance-in-patients-with-critical-limb-ischemia
#19
Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Eiji Shibahashi, Kensuke Shimazaki, Haruki Sekiguchi, Yuichiro Minami, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: Sensory disturbance (SD) is a common consequence of peripheral nerve damage associated with diabetes and severe ischemia. Progression of SD places patients at high risk for lower extremity ulcers and amputations. SD has been thought to be progressive and irreversible, and possibly caused by microvascular dysfunction. The aim of this study was to determine whether endovascular revascularization (EVR) induces quantifiable changes in SD in chronic critical limb ischemia (CLI) patients with neuropathy...
July 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28638953/-chronic-leg-ulcers
#20
REVIEW
J Dissemond
Chronic wounds often manifest as ulcers on the lower legs. The main causes of chronic leg ulcers are chronic venous insufficiency and/or peripheral arterial occlusive disease in approximately 80% of all patients. However, there are also numerous other potentially relevant factors which can cause or almost impede the healing of chronic leg ulcers. Therefore, disease such as vasculitis, livedo vasculopathy, pyoderma gangrenosum, necrobiosis lipoidica, Martorell hypertensive leg ulcer, calciphylaxis, infectious diseases, neoplasms, drugs, cutaneous artefacts and genetic defects are exemplarily presented...
August 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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