Venous ulcers, chronic wounds

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. 

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... 

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... 

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 chronic wounds [158]. 

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. 

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... 

As stated earlier, vmons leg ulceration is a common problem throughout the Western world. Venous 1 ulcers are the most fiequmitly occurring type of chronic wound accounting for over 70% of file lower extronity ulcoation and Ae recurrence rates are as hi( as 72% in one year. ... 

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. 

It should be stated that venous leg ulcers are chronic and there is no medication or surgery to cure the disease other than the compression therapy. A sustained graduated compression mainly enhances the flow of blood back to the heart, improves the functioning of valves and calf muscle pumps, reduces oedema, and prevents the swelling of veins. Mostly elderly people are prone to develop DVT, varicose veins, and venous leg ulcers. Venous leg ulcers are the most frequently occurring type of chronic wound, accounting for 80-90% of all lower extremity ulceration. 

Selkon JB, Cherry GW, Wilson JM, Hughes MA. Evaluation of hypochlorous acid washes in the treatment of chronic venous leg ulcers. J Wound Care 2006 15 (1) 33-7. 

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

Shifts in the cutaneous microbiome have also been noted in chronic ulcer disease, such as those caused by venous stasis or diabetes (175). Patients with chronic ulcers treated with antibiotics have been shown to have an increased abundance of Pseudomonadaceae while an increase in Streptococcaceae has been noted in diabetic ulcers (175). A longitudinal shift in wound microbiota has also been shown to coincide with impaired healing in diabetic mice, and may interact with aberrantly expressed host cutaneous defense response genes leading to ulcerogenesis (176). When compared to controls, the feet of diabetic men has also been noted to have decreased populations of Staphylococcus species, a relative increase in the population of S. aureus and increased bacterial diversity, which may increase the risk for wound infections in diabetic patients (177). 

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). 

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. 

Wound malodour is nq>idly becoming a critical issue, particularly wifi patients suffering with chronic illness that often result in wounds such as venous leg ulcers, diabetic ulcers, pressure ulcers and ftmgating (malignant cancerous) lesions. The malodour is usually just part of the vriiole chronic situation but it can affect the patient in numerous social and psychological ways. 

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. 

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