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Chronic leg ulcers

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https://www.readbyqxmd.com/read/28730726/changes-in-the-extracellular-matrix-surrounding-human-chronic-wounds-revealed-by-2-photon-imaging
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
June 21, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28635156/pyoderma-gangrenosum-and-underlying-diseases-in-japanese-patients-a-regional-long-term-study
#14
Sae Inoue, Jun-Ichi Furuta, Yasuhiro Fujisawa, Saori Onizawa, Shusaku Ito, Masayuki Sakiyama, Keiko Kobayashi, Toshiyuki Kanou, Shigeruko Iijima, Tsunao Ohi, Chimaki Okubo, Yoshihiro Moriyama, Naoko Okiyama, Manabu Fujimoto
Pyoderma gangrenosum (PG) is a chronic inflammatory disease of unknown cause that presents as an inflammatory and ulcerative disorder of the skin. PG is often associated with an underlying systemic disease. However, the frequencies of the underlying diseases are unclear in Japanese patients. In this retrospective, observational study, all patients diagnosed with PG who visited dermatology departments of nine regional hospitals in and around Ibaraki Prefecture were collected from 1982 to 2011 or 2014. The diagnoses of PG were based on the characteristic clinical and histological appearances and ruling out of infection...
June 21, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28619238/mesenchymal-stem-cell-in-venous-leg-ulcer-an-intoxicating-therapy
#15
REVIEW
Anjali Athanerey, Pradeep Kumar Patra, Awanish Kumar
Venous leg ulcers (VLU) are a prevalent and reoccurring type of complicated wound, turning as a considerable public healthcare issue, with critical social and economic concern. There are both medical and surgical therapies to treat venous leg ulcers; however, a cure does not yet exist. Mesenchymal stem cells (MSC) are capable and proved of accelerating wound healing in vivo and their study with human chronic wounds is currently awaited. MSCs are a promising source of adult progenitor cells for cellular therapy and have been demonstrated to differentiate into various mesenchymal cell lineages...
June 7, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28606546/advanced-multi-targeted-composite-biomaterial-dressing-for-pain-and-infection-control-in-chronic-leg-ulcers
#16
Ovidio Catanzano, Rachael Docking, Patricia Schofield, Joshua Boateng
This study aimed to develop advanced biomaterial polysaccharide based dressings to manage pain associated with infected chronic leg ulcers in older adults. Composite carrageenan (CARR) and hyaluronic acid (HA) dressings loaded with lidocaine (LID) and AgNPs were formulated as freeze-dried wafers and functionally characterized for porous microstructure (morphology), mechanical strength, moisture handling properties, swelling, adhesion and LID release. Antimicrobial activity of AgNPs was evaluated (turbidity assay) against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus whilst cell viability studies (MTT) was performed on normal adult human primary epidermal keratinocyte cells...
September 15, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28598763/chronic-venous-disease-and-wound-infection-approaches-prevention-and-outcome-measures-from-ewma
#17
Camila Fronzo
In May, BSN medical hosted two clinical symposia at the 2017 EWMA conference. These described the challenges in reducing the costs of treatment for patients with chronic venous disease (CVD), the importance of compression therapy and physical activity in the management and prevention of leg ulcers, and the obstacles in treating wound infection, among other topics. Camila Fronzo, JWC chief sub editor, was there to summarise the main points of each session.
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28594320/silver-containing-foam-dressings-with-safetac-a-review-of-the-scientific-and-clinical-data
#18
Phil Davies, Sara McCarty, Kristina Hamberg
Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag...
June 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28570137/benefits-of-maggot-debridement-therapy-on-leg-ulcers-a-literature-review
#19
Genevieve Abela
Maggot debridement therapy (MDT) is an effective method for debriding wounds such as leg ulcers, supporting the concept of wound bed preparation ( Dumville et al, 2009 ; Soares et al, 2009 ; Mudge et al, 2014 ). New evidence is emerging to suggest that maggots might contribute to wound healing in other ways. For example, the reduction of biofilms and disinfection of wounds ( Van Der Plas et al, 2008 ; Brown et al, 2012 ; Pritchard and Brown, 2015 ) plus regulation of protease levels ( Chambers et al, 2003 ; Van Der Plas et al, 2009a ; Van Der Plas et al, 2009b )...
June 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28567289/primary-cutaneous-b-cell-lymphoma-and-chronic-leg-ulcers-in-a-patient-with-type-2-diabetes
#20
Alessandro Mantovani, Fabrizia Perrone, Vincenzo Stoico, Isabella Pichiri, Laura Salvotelli, Ilaria Teobaldi, Massimiliano Bruti, Michela Conti, Luca Cima, Albino Eccher, Enzo Bonora
The incidences of type 2 diabetes mellitus and many cancers are rapidly increasing worldwide. Diabetes is a strong risk factor for some cancers (including lymphomas) and is also associated with adverse cancer outcomes. After gastrointestinal tract, the skin is the second most frequent extranodal site involved by non-Hodgkin lymphomas and the cutaneous B-cell lymphomas (CBCLs) range from 25% to 30% of all primary cutaneous lymphomas. The primary cutaneous diffuse large B-cell lymphoma (PCDLBCL) is an aggressive lymphoma with a poor prognosis, representing roughly 20% of all primary CBCLs...
2017: Endocrinology, Diabetes & Metabolism Case Reports
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