Dressings and topical agents for arterial leg ulcers

Nelson, E Andrea; Bradley, Matthew D

doi:10.1002/14651858.cd001836.pub2

Cited by 34 publications

(15 citation statements)

References 51 publications

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“…• Three of the excluded studies were Cochrane reviews on "dressings" for burns, 34 venous leg ulcers, 35 and arterial leg ulcers 36 and included only one HA study identified in this review (which ultimately was excluded-see reason later). In the Cochrane review on burns, 34 two of the trials identified earlier and included (Bettinger 1996, Liguori 1997 were not included in this Cochrane review.…”

Section: Excluded Reviews and Studies (N = 13)mentioning

confidence: 99%

See 1 more Smart Citation

Hyaluronic acid derivatives and their healing effect on burns, epithelial surgical wounds, and chronic wounds: A systematic review and meta‐analysis of randomized controlled trials

Voigt

Driver

2012

Wound Repair Regeneration

213

157

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Hyaluronic acid (HA) is a polysaccharide common to most species and is found in many sites in the human body, including the skin and soft tissue. A systematic review of the literature and meta-analysis was performed to identify randomized controlled trials, evaluating the use of HA derivatives in healing burns, epithelial surgical, and chronic wounds. Nine studies were identified, which met the search criteria and clinical endpoints of complete healing and percent wound size reduction when using HA vs. either an active or passive comparator. It was found in the vast majority of randomized controlled trials (eight of nine) that HA derivatives significantly improved the healing of wounds vs. traditional therapies or placebo (either via complete healing or a significant reduction in wound size) occurring from burns, venous insufficiency, diabetes, neuropathic insufficiency, and surgical removal of the epithelial layer (for tattoo removal). In the other remaining trial, one formulation of HA was compared with another, with the higher concentration showing improved application characteristics. Further, it was found in a meta-analysis in subsets of patients with diabetic foot ulcers (neuropathic) that HA derivatives healed these types of wounds significantly faster than standard of care. These studies in aggregate show that HA derivatives accelerate the healing process in burns, epithelial surgical wounds, and chronic wounds.

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Section: Excluded Reviews and Studies (N = 13)mentioning

confidence: 99%

“…In the Cochrane review on arterial ulcers, 36 there were no studies identified using HA as one of the treatment groups. This is consistent with the findings earlier-as no studies using HA with arterial ulcers were identified.…”

Section: Excluded Reviews and Studies (N = 13)mentioning

confidence: 99%

Hyaluronic acid derivatives and their healing effect on burns, epithelial surgical wounds, and chronic wounds: A systematic review and meta‐analysis of randomized controlled trials

Voigt

Driver

2012

Wound Repair Regeneration

213

157

View full text Add to dashboard Cite

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“…It is estimated that 1% of the Western adult population will suffer from a leg ulcer at some stage of their life. 2 In their 2001 publication, McGuckin et al 3 estimated that it costs US$3 billion each year solely to treat the symptoms of leg ulceration, not including the associated cost of approximately 2 million lost work days per annum. Leg ulcers become more common with age with the occurrence most common in the over 60s age demographic.…”

mentioning

confidence: 99%

The use of hyperbaric oxygen therapy to treat chronic wounds: A review

Thackham

McElwain

Long³

2008

Wound Repair Regeneration

177

124

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Chronic wounds, defined as those wounds which fail to proceed through an orderly process to produce anatomic and functional integrity, are a significant socioeconomic problem. A wound may fail to heal for a variety of reasons including the use of corticosteroids, formation of squamous cell carcinoma, persistent infection, unrelieved pressure, and underlying hypoxia within the wound bed. Hypoxia appears to inhibit the wound healing process by blocking fibroblast proliferation, collagen production, and capillary angiogenesis and to increase the risk of infection. Hyperbaric oxygen therapy (HBOT) has been shown to aid the healing of ulcerated wounds and demonstrated to reduce the risk of amputation in diabetic patients. However, the causal reasons for the response of the underlying biological processes of wound repair to HBOT, such as the up-regulation of angiogenesis and collagen synthesis are unclear and, consequently, current protocols remain empirical. Here we review chronic wound healing and the use of hyperbaric oxygen as an adjunctive treatment for nonhealing wounds. Databases including PubMed, ScienceDirect, Blackwell Synergy, and The Cochrane Library were searched for relevant phrases including HBOT, HBO/HBOT, wound healing, and chronic/nonhealing wounds/ulcers.

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“…Our own study however also shows that an extended primary hospital stay for wound treatment, followed by several consequent hospital stays for wound care (including minor and forefoot amputations, debridement), played an important role. Studies on modern treatment of arterial ulcer wounds, which include recommendations of a wound covering, are not available (Bendow et al 1999;Tautenhahn and Piatek 2006;Nelson and Bradley 2007). The principle of wound bed preparation is none the less valid for all chronic wounds.…”

Section: Discussionmentioning

confidence: 99%

The influence of polymorbidity, revascularization, and wound therapy on the healing of arterial ulceration

Tautenhahn

Lobmann

Koenig³

et al. 2008

VHRM

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Objective: An ulcer categorized as Fontaine's stage IV represents a chronic wound, risk factor of arteriosclerosis, and co-morbidities which disturb wound healing. Our objective was to analyze wound healing and to assess potential factors affecting the healing process. Methods: 199 patients were included in this 5-year study. The signifi cance levels were determined by chi-squared and log-rank tests. The calculation of patency rate followed the Kaplan-Meier method. Results: Mean age and co-morbidities did not differ from those in current epidemiological studies. Of the patients with ulcer latency of more than 13 weeks (up to one year), 40% required vascular surgery. Vascular surgery was not possible for 53 patients and they were treated conservatively. The amputation rate in the conservatively treated group was 37%, whereas in the revascularizated group it was only 16%. Ulcers in patients with revascularization healed in 92% of cases after 24 weeks. In contrast, we found a healing rate of only 40% in the conservatively treated group (p Ͻ 0.001). Revascularization appeared more often in diabetic patients (n = 110; p Ͻ 0.01) and the wound size and number of infections were elevated (p = 0.03). Among those treated conservatively, wound healing was decelerated (p = 0.01/0.02; χ² test). Conclusions:The success of revascularization, presence of diabetes mellitus, and wound treatment proved to be prognostic factors for wound healing in arterial ulcers.

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Dressings and topical agents for arterial leg ulcers

Cited by 34 publications

References 51 publications

Hyaluronic acid derivatives and their healing effect on burns, epithelial surgical wounds, and chronic wounds: A systematic review and meta‐analysis of randomized controlled trials

Hyaluronic acid derivatives and their healing effect on burns, epithelial surgical wounds, and chronic wounds: A systematic review and meta‐analysis of randomized controlled trials

The use of hyperbaric oxygen therapy to treat chronic wounds: A review

The influence of polymorbidity, revascularization, and wound therapy on the healing of arterial ulceration

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