Comparison of Outcomes in Patients With Venous Leg Ulcers Treated With Compression Therapy Alone Versus Combination of Surgery and Compression Therapy

Carvalho, Magali Rezende de

doi:10.1097/won.0000000000000079

Cited by 26 publications

(22 citation statements)

References 14 publications

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“…However, the choice of endovenous treatment method varied across recruiting centers. There is evidence to suggest that surgical obliteration of incompetent perforator veins may promote longer ulcer‐free periods and lower rates of recurrence, but the studies reported that the differences in compression and surgical groups were not statistically significant . A SR of the evidence of effectiveness of subfascial endoscopic perforator surgery for VLU treatment and prevention of recurrence is in progress …”

Section: Resultsmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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Compression therapy is the current evidence-based approach to manage venous leg ulcers (VLU); however, adherence is a major barrier to successful treatment. Combination approaches may relieve the burden of treatment by shortening the time to ulcer healing. This scoping review conducted by Australian researchers aimed to establish the evidence of effectiveness of various adjuvant methods on wound healing and recurrence. Randomized Controlled Trials (RCTs), and Systematic Reviews (SR) and Meta-Analyses (MA) on VLU management approaches published from January 2015 to December 2018 were included in this review. The articles included in the scoping review were grouped according to the management approaches, including (1) pharmaceutical interventions, (2) surgical interventions, (3) topical agents, (4) the use of devices, and (5) other, such as physiotherapy and psychological interventions. Results of this scoping review indicate that there is a limited high-quality evidence of effectiveness in most adjuvant therapies on wound healing and recurrence. Given the lowquality evidence observed in this scoping review for adjuvant treatments, the implication for practice is that current management guidelines be followed. Further rigorous studies have the potential to produce better quality evidence. Quality of evidence can be improved by ensuring large sample sizes of a single etiology wounds, standardizing reporting outcomes, and maintaining detailed and evidence-based protocols in physiological or psychological interventions.

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Section: Resultsmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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“…Besides treatment costs, some patients are unable to reconcile wound care therapy with the requirements of their jobs. These challenges may lead to lost wages or early retirement, as found in up to 12·5% of workers with venous ulcers in USA . We did not consider societal costs related to loss of production, because the patients registered in RUT have a median age of 80 years and as such will have retired from work.…”

Section: Discussionmentioning

confidence: 99%

Cost consequences due to reduced ulcer healing times – analyses based on the Swedish Registry of Ulcer Treatment

Öien

Forssell

Tennvall

2015

International Wound Journal

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Resource use and costs for topical treatment of hard-to-heal ulcers based on data from the Swedish Registry of Ulcer Treatment (RUT) were analysed in patients recorded in RUT as having healed between 2009 and 2012, in order to estimate potential cost savings from reductions in frequency of dressing changes and healing times. RUT is used to capture areas of improvement in ulcer care and to enable structured wound management by registering patients with hard-to-heal leg, foot and pressure ulcers. Patients included in the registry are treated in primary care, community care, private care, and inpatient hospital care. Cost calculations were based on resource use data on healing time and frequency of dressing changes in Swedish patients with hard-to-heal ulcers who healed between 2009 and 2012. Per-patient treatment costs decreased from SEK38 223 in 2009 to SEK20 496 in 2012, mainly because of shorter healing times. Frequency of dressing changes was essentially the same during these years, varying from 1·4 to 1·6 per week. The total healing time was reduced by 38%. Treatment costs for the management of hard-to-heal ulcers can be reduced with well-developed treatment strategies resulting in shortened healing times as shown in RUT.

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“…One author considered compression to be the first-line treatment for leg ulcers. 57 12. Surgery for leg ulcers: Samuel et al 58 did not identify any clinical trial.…”

Section: Compression Versus Surgery For Leg Ulcersmentioning

confidence: 99%