These data indicate that the FLQA-l is a reliable and valid questionnaire for the assessment of QoL in lymphedema. Since the QoL is impaired in many patients with lymphedema, QoL evaluation may be helpful for clinical diagnostics as well as for outcome measurement of specific edema therapy.

Propranolol may be the first-choice therapy for ulcerated haemangioma.

No abstract

The acceleration of wound healing is a major surgical concern. A triterpene extract from birch bark (Betulae cortex) experimentally enhances keratinocyte differentiation in vitro and accelerates wound healing ex vivo. We conducted an open, blind-evaluated, controlled, prospective, randomized (1:1) phase II clinical trial in patients requiring split-thickness skin graft transplantation at two university hospitals in Germany. Donor sites on the upper legs were covered with a moist silicone-coated dressing. Oleogel-S10 ointment containing 10% birch bark extract was randomly applied to the distal or proximal half of the wound, with the other half serving as an intraindividual control, for 14 days after the skin graft surgery. The primary efficacy variable was faster reepithelialization as determined from macrophotographs by independent, blinded experts. Twenty-four patients were randomized and completed the trial. After the 14-day test period, the planned interim analysis revealed a highly significant (p 0.0001) superiority of Oleogel-S10 in the primary efficacy variable and the trial was terminated early due to ethical concerns. The treatment side was also better reepithelialized and more similar to normal skin after 3 months. In conclusion, Oleogel-S10 significantly accelerated reepithelialization at split-thickness skin graft donor sites. Treatment with Oleogel-S10 was safe and well tolerated. i 2014 S. Karger AG, Basel

Background: Chronic venous insufficiency (CVI) is a frequent disease, reaching from mild ankle edema to severe venous leg ulcer. Previous studies have focused on the quality of life (QoL) in patients with leg ulcer, but not in patients with early forms of CVI nor stagerelated differences. Objective: To assess the quality of life in patients with CVI stages I, II, IIIa and IIIb (venous leg ulcer). Patients and Methods: Survey in a representative sample. 324 consecutive patients with different stages of CVI of a unit for phlebology and chronic wounds in the University hospital Freiburg were asked to answer validated questionnaires. In a period of 12 months, complete data were obtained from 276 patients. QoL was assessed by the Nottingham Health Profile (NHP), a generic QoL instrument, and the Freiburg Quality of Life Assessment (FLQA), a disease-specific questionnaire. The emotional status was assessed using the Symptom Checklist (SCL-90 R). Results: Qol was increasingly impaired from CVI stage I to CVI stage IIIb in the following areas: Pain and other physical complaints, physical mobility, energy level, social life, everyday life and stress due to treatment. In patients with CVI I QoL was only reduced in terms of sleep disturbances; patients with CVI II were also impaired in everyday life, pain and physical mobility. As a trend, QoL in CVI stage IIIa (healed leg ulcer) corresponded to stage II, whereas stage IIIb and mixed ulcer showed similar results. In most areas, female patients were more affected by QoL reductions. Neither age differences nor other sociodemographic parameters accounted for the stage differences of CVI. The general emotional status did not differ from normal population. Conclusions: QoL in patients with CVI can be severely impaired. The degree of impairment can at least partially be predicted by the stage of the disease. Reduction of QoL may have negative social as well as economic effects. The data suggest that psychosocial problems, including the question of QoL, should be considered in the treatment of CVI.