Chronic venous ulcers

Gohel MS, Windhaber RAJ, Tarlon JF, Whyman MR, Poskitt KR (2008) The relationship between cytokine concentrations and wound healing in chronic venous ulceration. J Vase Surg 48(5) 1272-1277... 

Andiiessen M, van Bergen B, Spruijt K, Go I, SchaUtwijk J, van de Kerkhof P (1995) Epidermal prohferation is not impaired in chronic venous ulcers. Acta Derm Venereol 75(6) 459 62... 

Taddeucci P, Pianigiani E, Colletta V, Torasso F, Andreassi L, Andreassi A. An evaluation of Hyalofill-F plus compression bandaging in the treatment of chronic venous ulcers. J Wound Care 2004 13 202-204. 

Early observations showed quicker healing, decreased infection, and reduced pain. Throughout the years, AM has been used to treat bums, surgical wounds, diabetic foot ulcers, chronic venous ulcers, and pressure ulcers. 

There was significantly increased activity of both total NOS (P <0.04) and iNOS (P <0.05) in chronic venous ulcer tissue compared with normal skin, and significantly increased activity of arginase (P... 

Herrick SE, Sloan P, McGurk M, et al. Sequential changes in histologic pattern and extracellular matrix deposition during the healing of chronic venous ulcers. Am J Pathol 1992 141(5) 1085 1095. 

The efficacy of chitosan in the treatment of leg ulcers stems from its antiinflammatory action and stimulation of epithehahzation. Chitosans stimulate the granulation process and the epidermis formation, thus accelerating heahng, even in the elderly suffering from chronic venous insufficiency, the... 

K. Roztocil, V. Stvrtinova and J. Strejcek, Efficacy of a 6-month treatment with Daflon 500 mg in patients with venous leg ulcers associated with chronic venous insufficiency. Int. Angiol. 22 (2003) 24-32. 

Kopera D, Kokol R, Berger C, Haas J (2005) Does the use of low-level laser influence wound healing in chronic venous leg ulcers J Wound Care 4(8) 391-394... 

Wlaschek M, Scharffetter-Kochanek K (2005) Oxidative stress in chronic venous leg ulcers. Wound Repair Regen 13(5) 452 61... 

Harris IR, Yee KC, Walters CE, Cunliffe CE, Kearney IN, Wood EJ et al (1995) Cytokines and protease levels in healing and non-healing chronic venous leg ulcers. Exp Dermatol 4 342-349... 

Lyseng-Williamson KA, Perry CM. 2003. Micronised purified flavonoid fraction A review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs 63 71-100. 

Post-phlebrtic syndrome, a complication of acute DVT is estimated to occur in approximately 4% of the population (213). This syndrome is characterized by persistent pain, edema, hyperpigmentation, induration of the skin, and stasis ulceration (214). The post-phlebrtic syndrome may be due to venous hypertension as a result of outflow obstruction or damage to the valves and in the cutaneous microcirculation may manifest as tissue hypoxia and lymphatic obstruction. Chronic venous insufficiency may lead to post-phlebetic syndrome. The syndrome may be the result of abnormalities in the superficial, the perforator, or the deep venous system. The diagnosis is purely clinical. The pharmacologic treament of post-phlebetic syndrome is rather limited, with pentoxifylline reported to improve the healing rate of skin ulcers. 

Patients with chronic venous insufficiency and venous leg ulcers are at risk of sensitization to topical medications. The frequency of sensitization in these patients is up to 67% (11). In a study using an expanded European standard series and 20 different wound dressings for patch-testing in 36 patients with chronic venous insufficiency, sensitization to fragrance mix was found in three cases (12). 

The client diagnosed with chronic venous insufficiency has a venous stasis ulcer that is being treated with autolytic medication for debridement and an occlusive dressing. The nurse notices a foul-smelling odor. Which action should the nurse take ... 

Hepatic Effects. Ingestion of 3.5 mg/kg/day zinc sulfate for 18 weeks by 13 patients being treated for chronic venous leg ulcers was reported to have no effect on the results of liver function tests (Hallbook and banner 1972). However, the type of liver function tests was not specified and results were not presented to support this conclusion. 

Renal Effects. Thirteen patients treated with zinc sulfate at 3.5 mg zinc/kg/day for 18 weeks for chronic venous leg ulcers had normal urinalyses (Hallbook and banner 1972). However, neither the specific parameters measured for the urinalysis nor the results were presented to support this conclusion. Furthermore, urinalysis may not be a sensitive indicator of renal function. 

Zerm, R., 2013. Local treatment of chronic wounds in patients with peripheral vascular disease, chronic venous insufficiency and diabetes topical honey for diabetic foot ulcers. Deutsches Arzteblatt International 110 (21), 373. 

Alvarez, 0. M., Patel, M., Booker, J., and Markowitz, L. (2004). Effectiveness of a biocellulose wound dressing for the treatment of chronic venous leg ulcers Results of a single center randomized study involving 24 patients. Wounds, 16, 224-233. 

Lee G, Rajendran S, Anand SC. Novel single layer compression bandage system for the treatment of chronic venous leg ulcers. British J Nursing 2009 18(15) S4—S18. 

Brehmer, F., et al. Alleviation of chronic venous leg ulcers with a hand-held dielectric barrier discharge plasma generator (PlasmaDerm (R) VU-2010) results of a monocentric, two-armed, open, prospective, randomized and controlled trial (NCT01415622). Journal of the European Academy of Dermatology and Venereology 29(1), 148-155 (2015)... 

G Lee, S Rajendran and S C Anand, Single-layer compression bandage system for chronic venous leg ulcers , British J of Nursing, 13 August 2009 S4-S18. 

Ward DJ, Bennett JP, Burgos H, Fabre J. The healing of chronic venous leg ulcers with prepared human amnion. BrJ Plast Surg July 1989 42(4) 463-7. 

Sibbald RG, Contreras-Ruiz J, Coutts P, Fierheller M, Rothman A and Woo K, Bacteriology, inflammation, and healing a study of nanocrystafline silver dressings in chronic venous leg ulcers . Advances in Skin ( Wound Care, 20 (10), 2007, pp 549-558. 

Moffatt,C.J.,Franks,P.J.,Doherty,D.C.Martin,R.,Blewett,R.and Ross,F. (2004) Prevalence of leg ulceration in a London population. QJM, 97,7,431—437. Nicholaides, A.N. (1997) Investigation of chronic venous insufficiency a consensus statement (France, 5-9 March). Circulation 2000, 102, 20, E126-E163. 

Standard compression therapy for leg ulcers in chronic venous insufficiency has been compared with compression therapy plus Dafion in 150 patients. The addition of Dafion was associated with significantly more healed ulcers and significant improvement in the sensation of heavy legs no treatment-related adverse reactions were reported [IT]. 

Chronic venous disorders are one of the most common ailments affecting mankind in the world today (Callam 1994). In the Netherlands, government authorities do not record the instance of venous disorders, with the exception of patients admitted to hospitals for venous surgery or for complications such as venous ulceration. In other countries the situation is similar, meaning that exact numerical data are not available. 

Brandjes DPM, Biiller HR, Heyboer H, Huisman MV, de Rijk M, Jagt H, ten Cate JW (1997) Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet 349 759-762 Brantingham CR, Beekman BE, Moss CN, Gordon RB (1970) Enhanced venous pump activity as a result of standing on a varied terrain floor surface. J Occup Med 12 164-169 Callam MJ (1992) Prevalence of chronic leg ulceration and severe chronic venous disease in western countries. Phlebology Suppl 1 6-12... 

Da Silva A, Widmer LK, Martin H, et al. (1974) Varicose veins and chronic venous insufficiency. Vasa 2 118-125 Fagrell B (1982) Microcirculatory disturbances - the final cause for leg ulcers Vasa 11 101-103... 

Laing, A.C., et al., 2011. The effects of pad geometry and material properties on the biomechanical effectiveness of 26 commercially available hip protectors. J. Biomech. 44,2627-2635. Lee, G., Rajendran, S., Anand, S., 2009. New single-layer compression bandage system for chronic venous leg ulcers. Br. J. Nurs. 18, S4—S18. 

---