Comparative systematic review and meta-analysis of compression modalities for the promotion of venous ulcer healing and reducing ulcer recurrence

Mauck, Karen F.; Asi, Noor; Elraiyah, Tarig; Undavalli, Chaitanya; Nabhan, Mohammed; Altayar, Osama; Sonbol, Mohamad Bassam; Prokop, Larry J.; Murad, M. Hassan

doi:10.1016/j.jvs.2014.04.060

Cited by 87 publications

(69 citation statements)

References 37 publications

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“…The authors present their findings observed in patients that could encourage the use of aloe as a topical treatment for venous ulcers. Aloe could be an interesting alternative to other approaches, thanks to its anti-inflammatory, antibacterial and analgesic properties, but these studies use very small samples [72]. Aloe vera is used with good results in dermatology and oncology [7,9].…”

Section: Discussionmentioning

confidence: 99%

Complementary Medicine and Venous Ulcers: Review of Literature

Se¹

2017

Health Care Current Reviews

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Introduction: Complementary medicine has ancient historical roots and its use is constantly changing. It alongside scientific medicine is useful in the treatment of many diseases, including oncological, respiratory, and dermatological. It is used in the treatment of pain and in the local treatment of various ulcers (lesions) skin. In particular, scientific medicine uses several treatments for venous ulcers with not completely effective outcomes. Effective treatment prevents complications and improves the quality of life of patients. There is scientific evidence on the efficacy of complementary medicine in the treatment of venous ulcers of the lower limbs. Methods:It was performed as a literature review on the databases: MEDLINE, EMBASE and COCHRANE with the aim of detecting the evidence of efficacy of complementary medicine interventions in the treatment of venous ulcers and ways to treat it. We used the keywords and thesaurus descriptors for complementary medicine. We included the following drawings of relevant studies to the subject of the research: systematic reviews randomized controlled trials (RCTs), case control studies, observational studies, case reports, studies, and expert opinion in English, conducted on humans. For the purpose of this research, 174 documents were identified, of which only 15 were relevant and were within the inclusion criteria.Results: An analysis of the literature shows that many studies have evaluated the effectiveness of aloe, calendula, standardized extract from the aerial parts of A. pichinchensis, Mimosa tenuiflora, modified linen bandages, products made of honey found on the market, herbal therapies, polarized light therapy combined with herbal and plant biomembranes. However, these findings are insufficient to support or deny that one treatment is more effective than another. These results are not widely generalizable because of the low number of samples studied. Conclusion:Despite the interest in complementary medicine and the treatment of venous ulcers, there is currently no truly effective treatment strategy. The detected evidence is insufficient to make significant changes in the treatment of venous leg ulcers with complementary medicine interventions. The available studies on the treatment of venous leg ulcers with products based on plants have not established the existence of a treatment that may be effective individually. Additional studies would be needed to demonstrate the efficacy of these treatments.

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Section: Discussionmentioning

confidence: 99%

Complementary Medicine and Venous Ulcers: Review of Literature

Se¹

2017

Health Care Current Reviews

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“…(11) Based on the systematic review with meta-analysis about the compressive modalities and the healing of the varicose ulcer, it was verified that the compressive effect on the varicose ulcer relapse is still based on low-quality evidence. (12) The ideal pressure measure of the stocking to prevent relapse remains undefined, in view of difference between the levels in the literature. (13) Venous insufficiency in the lower limbs is frequent in the general population, in Western countries, and is more common in women and elderly people.…”

Section: Discussionmentioning

confidence: 99%

Prevenção de recidiva de úlcera varicosa: um estudo de coorte

et al. 2016

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Objective: Determine the relapse rate of varicose ulcer and check the association between relapse and prevention measures adopted. Methods: Cohort study involving 50 patients over 18 years of age post-healing of varicose ulcer monitored over ten years. Relapse was assessed through direct inspection during the clinical assessment, and the preventive measures used were informed by the patient. Pearson's chi-square test was used with p ≤0.05. Results: Relapse of varicose ulcer corresponded to 62.2%, mostly in women, followed by elderly, illiterate and retired people. The following combination was effective to prevent relapses: use of compressive stockings, rest and application of moisturizer. Conclusion: The relapse rate of varicose ulcer was high and the main combination of preventive measures applied was the use of compressive stockings, rest and application of moisturizer. ResumoObjetivo: Determinar a taxa de recidiva de úlcera varicosa, e verificar a associação entre recidiva e medidas de prevenção adotadas. Métodos: Estudo de coorte com 50 pacientes maiores de 18 anos com úlcera varicosa pós-cicatrização acompanhados durante 10 anos. A recidiva foi avaliada por meio de inspeção direta durante a avaliação clínica, e as medidas de prevenção usadas foram informadas pelo paciente. Utilizou-se o teste qui quadrado de Pearson, sendo significante p-value ≤0,05. Resultados: A recidiva de úlcera varicosa foi de 62,2%, a maioria em mulheres, seguida por idosos, analfabetos e aposentados. Mostrou-se medida eficaz na prevenção de recidivas o seguinte conjunto: uso da meia de compressão, repouso e aplicar creme hidratante. Conclusão: A taxa de recidiva de úlcera varicosa foi elevada e as principais medidas de prevenção aplicadas em conjunto foram usar meia de compressão, repousar e aplicar creme hidratante.

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“…For example, patients with venous ulcers, and also those with severe lymphedema, should be managed with compression bandages until the ulcers are healed or no further reduction of lymphedema is seen. This concept, based on the results of randomized clinical trials (RCT), is endorsed by several guidelines [9][10][11][12][13][14].…”

Section: Clinical Indicationsmentioning

confidence: 99%

“…For the use of compression bandages strong recommendations can be given in patients with venous ulcers (CEAP C6) [11][12][13] and for management of lymphedema [9,18].…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

“…In the field of venous ulceration an extensive Cochrane review [11] and a recent recommendation from the American Venous Forum [12], together with a meta-analysis from the Mayo Clinic [13], emphasized that compression bandages are the mainstay of conserv- ative therapy of venous leg ulcers. A randomized controlled trial from Hong Kong, which has changed the conventional concept of leg ulcer treatment in that area, showed a healing rate that was more than twice as high with bandages compared to the usual local ulcer treatment without compression.…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

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Compression bandages or stockings in phlebolymphology?

Partsch¹

2014

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According to the classical therapeutic concept, compression stockings are primarily used in milder forms of chronic venous insufficiency and for long-term maintenance therapy for lymphedema, while compression bandages are applied in severe stages (e.g. in venous ulcers) and for the initial decongestion therapy in lymphedema. This concept is mainly supported by the different therapeutic pressure exerted by stockings and bandages. While stockings do not exceed a pressure range of 40-50 mmHg in either body position, properly applied bandages start with a resting pressure of 50-60 mmHg, which rises by an additional 20-40 mmHg during standing or walking, depending on the stiffness of the material. The higher therapeutic pressure exerted by compression bandages explains their hemodynamic advantage, which has been demonstrated by experiments comparing the efficacy of stockings in improving the venous calf pump. In addition, in this review some practical aspects are underlined, and clinical evidence reported in the literature is discussed.

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Comparative systematic review and meta-analysis of compression modalities for the promotion of venous ulcer healing and reducing ulcer recurrence

Cited by 87 publications

References 37 publications

Complementary Medicine and Venous Ulcers: Review of Literature

Complementary Medicine and Venous Ulcers: Review of Literature

Prevenção de recidiva de úlcera varicosa: um estudo de coorte

Compression bandages or stockings in phlebolymphology?

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