Leg ulcer

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... 

Cadexomer-H is an iodophor similar to povidone-iodine. It is a 2-hydroxymethylene crosslinked (1-4) a-D-glucan carboxymethyl ether containing iodine. The compound is used especially for its absorbent and antiseptic properties in the management of leg ulcers and pressure sores where it is applied in the form of microbeads containing 0.9% iodine. 

Hydroxyurea inhibits cell synthesis in the S phase of the DNA cycle. It is used selectively in the treatment of psoriasis, especially in those with liver disease who would be at risk of adverse effects with other agents. However, it is less effective than methotrexate. The typical dose is 1 g/day, with a gradual increase to 2 g/day as needed and as tolerated. Adverse effects include bone marrow toxicity with leukopenia or thrombocytopenia, cutaneous reactions, leg ulcers, and megaloblastic anemia. 

Rare painless hematuria normal Hb level heavy exercise under extreme conditions may provoke gross hematuria and complications Pain crises, microvascular disruption of organs (spleen, liver, bone marrow, kidney, brain, and lung), gallstone, priapism, leg ulcers, anemia (Hb 7-10 g/dL) Painless hematuria and rare aseptic necrosis of bone vasoocclusive crises are less common and occur later in life other complications are ocular disease and pregnancy-related problems mild anemia (Hb 10-12 g/dL)... 

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. 

RD.C. Smith, From skin disorders to venous leg ulcers pathophysiology and efficacy of Daflon 500 mg in ulcer healing. Angiology 54 (Suppl. 1) (2003) S45-S51. 

M/sce//aneons - Asthenia, back pain, bacterial infection, chest pain, fever, flu-like symptoms, flushing, hot flushes, intermittent claudication, leg ulcer, malaise, moniliasis, ptosis, rigors, varicose vein, viral infection. 

Potent opioids act through opioid receptors in the central nervous system where they inhibit the transport of pain impulses. They are mostly used for treatment of malignant cancer pain and for post-operative pain. Severe, long-term non-malignant pain, e.g. in ischaemic leg ulcers, sometimes necessitates the use of opioids. The risk of treatment discontinuation due to adverse reactions is high. 

Infections (such as pyelonephritis, cellulitis, osteomyelitis, wound infection, leg ulcer, septic arthritis, diarrhea, bronchitis, and pneumonia) occur in 38%-29% of patients. 

Vitamin deficiency is seldom seen, and its symptoms of leg ulceration (cheilosis), skin symptoms, a purplish tongue, eye disturbances, and photophobia are vague. 

Sodium Hyaluronate Cream For leg ulcer, diabetic ulcer etc. 

Oxidant and Antioxidant Status of Patients with Chronic Leg Ulcer Before and After Low Intensity Laser Therapy... 

Keywords Antioxidants Catalase Chronic leg ulcer Glutathione peroxidase... 

The aim of the present study was to evaluate the effect of LLLT on oxidative markers in serum and tissue biopsies of healing ulcers before and after the 8th session of an LLLT course of chronic leg ulcer treatment. Oxidative damage was assessed in terms of lipid peroxidation reflected by serum malondialdehyde (MDA) level, protein oxidation was measured in terms of tissue protein carbonyls (PCb), and DNA damage was measured in terms of DNA fragmentation. Antioxidative activity was estimated by measuring activity of SOD, GPX and CAT enzymes. 

Twenty two chronic leg ulcers patients, not amenable to surgical interface or reconstruction and not responding to conventional treatment, were included in this study. The patients were of the middle class population of mean age 48.5 14.6 years. Their ulcers were umesponsive to conservative treatment for a duration that ranged between 3 to 17 years (mean of 14.67 4.66 years). 

LLLT Effects on Clinical Healing of Chronic Leg Ulcers... 

Fig. 27.1 Chronic leg ulcers of a 60 years old male patient before and after laser therapy, three sessions per week at energy fluence of 0.5 J cm , He-Ne laser. Duration of ulcer was 16 months...

PCb (Fig. 27.4) (percentage/total protein) was significantly higher among patients with chronic leg ulcer when compared to normal controls (0.85 0.14% vs... 

Fig. 27.2 Chronic leg ulcers on the lateral lower half of the leg of a 45 years old male patient before (a) and after laser therapy (b). Duration of ulcer was 2 years and the ulcer size before treatment was 5 cm. This patient received three sessions per week of 0.5 Jcm He-Ne laser LETT and complete healing was achieved in the 12th session...

Fig. 27.4 Level of tissue protein carbonyls, DNA fragmentation and serum MDA in normal and chronic leg ulcer patients before and after LLLT total, in low and high response groups...

It is concluded that chronic leg ulcer patients probably lack the mechanisms that normalise their levels of antioxidant enzymes, which normally decrease at early stages of wound healing in order to allow blood granulocytes and tissue macrophages to perform their function in cleansing the wounded area. Consequently re-epitheUalisation and matrix remodeling processes are delayed. LLLT stimulates... 

Hamer C, Cullum N, Roe B (1994) Patients perceptions of chronic leg ulcers. J Wound Care 3 99-101... 

Ebbeskog B, Ekman SL (2001) Elderly persons experiences of Uving with venous leg ulcer living in a dialectal relationship between freedom and imprisonment. Scand J Caring Sci 15 235-243... 

El Batanouny M, Shokeir H, Zayed A, Korraa S, Kamali A (2004) Enhanced healing effects of low energy irradiation on chronic leg ulcers of different etiologies. Dermatology and Andrology 24(1-4) 11-22... 

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... 

Kokol R, Berger C, Haas J, Kopera D (2005) Venous leg ulcers no improvement of wound healing with 685-nm low level laser therapy Randomized, placebo-controlled, double-blind study. Hautarzt 56(6) 570-575... 

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

Schmidtchen A (2000) Degradation of antiproteinases, complement and fibronectin in chronic leg ulcers. Acta Derm Venereol 80(3) 179-184... 

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... 

B. Indications and nse Regranex Gel is indicated for the topical treatment of deep diabetic foot and leg ulcers that have an adequate blood supply. Patients with diabetes who develop chronic ulcers of the foot and leg are at higher risk for local and systemic infections and amputation. 

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