Venous leg ulcers

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. 

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... 

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... 

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... 

Briggs M, Nelson EA. Topical agents or dressings for pain in venous leg ulcers. Cochrane Database Syst Rev. 2003 CD001177. 

Argyria, also called argyrism or argyrosis, which occurs as a result of prolonged silver therapy, was first reported in 1647 [11], and was reviewed in depth by Hill and Pillsbury [11] in 1939. It presents as an irreversible grey to blue-black colouring of the skin and mucous membranes, for example, the conjunctiva, and also of internal tissue. With the decline in use of many silver preparations in therapeutics, the condition is less likely to be encountered today. However, a recent case has been reported in a 59-year old patient undergoing silver sulphadiazine therapy for recurrent venous leg ulcers [12],... 

Vasodilators such as naftidrofuryl (Praxilene) and oxpentifylline (pentoxifylline) (Trental) increase blood flow to skin rather than muscle they have also been successfully used in the treatment of venous leg ulcers (varicose and traumatic). 

Skin graft product Apligraf (Organogenesis/N ovartis) Wound healing of venous leg ulcers diabetic foot ulcers... 

Vapor permeable adhesive films derived from materials found in some tissues are being used more commonly in wound management. Most of the available films are composed of industrially manufactured and purified benzyl ester derivatives of hyaluronic acid and may be used for direct application to wounds such as diabetic foot ulcers or venous leg ulcers or as scaffolds for the cultivation of fibroblasts and keratinocytes for further transplantation. 

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). 

Dupre D, Schoenlaub P, Coloigner M, Plantin P. Reaction anaphylactique apres injection locale de GM-CSF au cours d un ulcere veineux de jambe. [Anaphylactic reaction after local injection of GM-CSF in venous leg ulcer.] Ann Dermatol Venereol 1999 126(2) 161. 

Peripheral neuropathy from long-term treatment of venous leg ulcers with silver sulfadiazine cream has been observed in one patient (13). 

Zinc Sulphate in Patients with Venous Leg Ulceration, Lancet (1970) 2, 889. 

Cabrera J, Redondo P, Becerra A, et al. Ultrasound-guided injection of polidocanol microfoam in the management of venous leg ulcers. Arch Dermatol 2004 140(6) 667-673. 

High molecular size HA preparations, applied topically, promote healing of fresh skin wounds [156]. They also promote the healing of venous leg ulcers [157] and are useful in the management of chronie wounds [158]. 

G12. Greaves, M., and Boyde, T. R. C., Plasma zinc concentrations in patients with psoriasis, other dermatoses and venous leg ulcerations. Lancet ii, 1019-1020 (1967). 

Cadexomer Iodine is a hydrophilic, modified staurch polymer containing 0.9% iodine within the helical structure it is used in the treatment of decubitus and venous leg ulcers. Applied to a wound surface as a powder, it is reported to accelerate healing, stimulate granulation, clean the ulcer surface, relieve pain and reduce bacterial counts. 

Vin F, Teot L, Meaume S. The healing properties of Promogran in venous leg ulcers. J Wound Care 2002 11 335-341. 

C Pierard-Franchimont, P Paquet, JE Arrese, GE Pierard. Healing rate and bacterial necrotizing vasculitis in venous leg ulcers. Dermatology 194 383-387, 1997. 

Wolcott, R. D., Gontcharova, V., Sun, Y., and Down, S. E. (2009). Evaluation of the bacterial diversity among and within individual venous leg ulcers using bacterial tag-encoded FLX and titanium amplicon pyrosequencing and metagenomic approaches. BMC Microbiol. 9, 226. 

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. 

Greaves MW, Skillen AW. 1970. Effects of long-continued ingestion of zinc sulphate in patients with venous leg ulceration. Lancet ii 889-891. 

HallbookT, Lanner E. 1972. Serum-zinc and healing of venous leg ulcers. Lancet ii 780-782. 

Thomas, S., 1998. Compression Bandaging in the Treatment of Venous Leg Ulcers. World Wide Wounds. 

Wounds can be classified into acute wounds and chronic wounds. While acute wounds take only a few weeks to heal, chronic wounds require several months to heal completely. Chronic wounds include venous leg ulcers and pressure sores. Wounds are not usually sterile. A wound may bear a level of 100,000 microorganisms per gram of tissue. Beyond this number, the wound may become infected. In some wounds the pathogens may be able to colonise (critical colonisation) and this is considered to be detrimental for wound healing. Wound bacteria can be acquired from the patient s own endogenous flora or from exogenous microbial contamination... 

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. 

An innovative research and development programme has been undertaken in the University of Bolton into the development of a smart single layer novel compression therapy system for the treatment of venous leg ulcers. The novel single layer... 

Cullum N. Compression for venous leg ulcers. Cochrane Review. Oxford The Cochrane Library 2002. 

---