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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/29450466/diagnostic-criteria-of-ulcerative-pyoderma-gangrenosum-a-delphi-consensus-of-international-experts
#3
Emanual Maverakis, Chelsea Ma, Kanade Shinkai, David Fiorentino, Jeffrey P Callen, Uwe Wollina, Angelo Valerio Marzano, Daniel Wallach, Kyoungmi Kim, Courtney Schadt, Anthony Ormerod, Maxwell A Fung, Andrea Steel, Forum Patel, Rosie Qin, Fiona Craig, Hywel C Williams, Frank Powell, Alexander Merleev, Michelle Y Cheng
Importance: Pyoderma gangrenosum is a rare inflammatory skin condition that is difficult to diagnose. Currently, it is a "diagnosis of exclusion," a definition not compatible with clinical decision making or inclusion for clinical trials. Objective: To propose and validate diagnostic criteria for ulcerative pyoderma gangrenosum. Evidence Review: Diagnostic criteria were created following a Delphi consensus exercise using the RAND/UCLA Appropriateness Method...
February 14, 2018: JAMA Dermatology
https://www.readbyqxmd.com/read/29449960/physician-initiated-clinical-study-of-limb-ulcers-treated-with-a-functional-peptide-sr-0379-from-discovery-to-a-randomized-double-blind-placebo-controlled-trial
#4
Hironori Nakagami, Ken Sugimoto, Takahiro Ishikawa, Taku Fujimoto, Toshifumi Yamaoka, Misa Hayashi, Eiji Kiyohara, Hiroshi Ando, Yuta Terabe, Yoichi Takami, Koichi Yamamoto, Yasushi Takeya, Minoru Takemoto, Masaya Koshizaka, Tamotsu Ebihara, Ayumi Nakamura, Mitsunori Nishikawa, Xiang Jing Yao, Hideki Hanaoka, Ichiro Katayama, Koutaro Yokote, Hiromi Rakugi
SR-0379 is a functional peptide that has wound healing effect with anti-microbial action, making it an ideal drug to prevent infection. To evaluate the safety, efficacy, and pharmacokinetics of SR-0379 for the treatment of leg ulcers, a physician-initiated, phase I/IIa, first-in-patient clinical study was designed. A multi-center, double-blind, randomized clinical study was conducted from October 2015 to September 2016. The inclusion criteria for leg ulcers were (1) diabetes or critical limb ischemia and (2) wound size <6 cm in diameter...
2018: NPJ Aging and Mechanisms of Disease
https://www.readbyqxmd.com/read/29446252/what-is-the-effect-of-exercise-on-wound-healing-in-patients-with-venous-leg-ulcers-a-systematic-review
#5
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
#6
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
#7
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/29433381/collateral-circulation-between-angiosomes-in-the-feet-of-diabetic-patients
#8
Erkan Orhan, Ömer Özçağlayan
Objectives The main factor in the healing of foot ulcers in diabetic patients is adequate perfusion. There is no consensus on whether direct or indirect revascularization is more effective in leg revascularization. At the centre of that debate, there is a disagreement about whether collateral circulation is sufficient or not. Our aim is to evaluate collateral circulation activity between angiosomes in the feet of diabetic patients by evaluating the level of occlusion in leg arteries and comparing the angiosome regions that have necrosis...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29425655/could-essential-oils-enhance-biopolymers-performance-for-wound-healing-a-systematic-review
#9
REVIEW
Mercedes Pérez-Recalde, Ignacio E Ruiz Arias, Élida B Hermida
BACKGROUND: Millions of people in the world suffer from chronic wounds of different etiologies such as diabetic foot and leg ulcers, without solutions nowadays. Molecules obtained from plants offer an alternative to aid wound healing. Strong evidence about essential oils (EO) anti-inflammatory and antimicrobial properties is thoroughly described in literature and their chemical compositions are well characterized. More recently, EO effects in experimental wounds have begun to be analyzed...
January 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/29425540/-when-to-ask-for-a-skin-biopsy-in-a-patient-with-leg-ulcer-retrospective-study-of-143-consecutive-biopsies
#10
A Stansal, K Khayat, V Duchatelle, E Tella, V Gautier, D Sfeir, R Attal, I Lazareth, P Priollet
OBJECTIVE: A vascular cause is found in around 85% of leg ulcer patients, but non-vascular causes are also observed. Their diagnosis is based on a set of clinical arguments and skin biopsy with histological analysis. The aim of this study was to analyze the results of these biopsies and to find common criteria for ulcers whose skin biopsies had led to the diagnosis of a non-vascular ulcer. MATERIAL AND METHOD: A retrospective study was carried out on the analysis of 143 skin biopsies of leg ulcers...
February 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29424645/micrografting-chronic-lower-extremity-ulcers-with-mechanically-disaggregated-skin-using-a-micrograft-preparation-system
#11
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
#12
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
#13
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/29422826/role-of-plasma-growth-factor-in-the-healing-of-chronic-ulcers-of-the-lower-legs-and-foot-due-to-ischaemia-in-diabetic-patients
#14
Tomasz Miłek, Krzysztof Baranowski, Piotr Zydlewski, Piotr Ciostek, Krzysztof Mlosek, Wojciech Olszewski
Introduction: It has been demonstrated that plasma growth factor (PGF) responsible for proliferation of smooth muscle cells and fibroblasts significantly shortens treatment duration. Aim: To determine the role of human growth factor in the healing of ulcers due to ischaemic diabetic foot syndrome (DFS) following previous angioplasty of the blood vessels of the lower leg and foot. Material and methods: The study group included 50 patients with ischaemic diabetic foot complicated by lower leg ulcers in which angioplasty of the stenotic arteries in the distal lower leg and foot was performed...
December 2017: Postȩpy Dermatologii i Alergologii
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
#15
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
#16
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/29380178/%C3%AE-thalassemia-intermedia-a-comprehensive-overview-and-novel-approaches
#17
REVIEW
Chingiz Asadov, Zohra Alimirzoeva, Tahira Mammadova, Gunay Aliyeva, Shahla Gafarova, Jeyhun Mammadov
β-Thalassemia intermedia is a clinical condition of intermediate gravity between β-thalassemia minor, the asymptomatic carrier, and β-thalassemia major, the transfusion-dependent severe anemia. It is characterized by a significant clinical polymorphism, which is attributable to its genetic heterogeneity. Ineffective erythropoiesis, chronic anemia, and iron overload contribute to the clinical complications of thalassemia intermedia through stepwise pathophysiological mechanisms. These complications, including splenomegaly, extramedullary erythropoiesis, iron accumulation, leg ulcers, thrombophilia, and bone abnormalities can be managed via fetal hemoglobin induction, occasional transfusions, chelation, and in some cases, stem cell transplantation...
January 29, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29378357/predictors-of-post-thrombotic-ulcer-after-acute-dvt-the-riete-registry
#18
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/29373203/a-prospective-study-to-evaluate-complete-wound-healing-and-limb-salvage-rates-after-angiosome-targeted-infrapopliteal-balloon-angioplasty-in-patients-with-critical-limb-ischaemia
#19
Ahmed Elbadawy, Haitham Ali, Mahmoud Saleh, Ayman Hasaballah
OBJECTIVE/BACKGROUND: To evaluate complete wound healing and limb salvage rates in patients with critical limb ischaemia (CLI) with concurrent foot ulceration/gangrene who underwent angiosome targeted infrapopliteal balloon angioplasty. METHODS: This was a prospective observational study. In total, 212 patients who underwent successful infrapopliteal balloon angioplasty to assist wound healing and achieve limb salvage were included from June 2014 to March 2016. Propensity score matching was developed to compare complete wound healing, 1 year amputation free survival (AFS), and limb salvage rates between the two study groups (direct revascularisation [DR] and indirect revascularisation [IR])...
January 16, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29368880/the-influence-of-exercise-on-ulcer-healing-in-patients-with-chronic-venous-insufficiency
#20
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
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