Subcutaneous fasciotomy and eradication of superficial venous reflux for chronic and recurrent venous ulcers: mid-term results

Christenson, Jan T.; Prins, Christa; Gemayel, Gino

doi:10.1258/phleb.2010.010026

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…По данным J.T. Christenson, C. Prins, G. Gemayel, ликвидация всех поверхностных рефлюксов снижает подкожное тканевое давление, в то время как дополнительная паратибиальная фасциотомия снижает ICP и подкожное тканевое давление, увеличивая чрескожное напряжение кислорода, что, по-видимому, способствует эпителизации VLU [77].…”

Section: флебологияunclassified

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Katorkin

Kushnarchuk

2023

Ambulatornaya khirurgiya

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A review of the literature is presented, including data on the incidence, pathophysiology, and clinical picture of patients with chronic compartment syndrome (CCS) of the lower extremities. Chronic exercise compartment syndrome (CECS) is characterized by pain with repetitive exertion and increased intracompartmental pressure affecting the lower extremities in physically active patients. In severe chronic venous insufficiency of the lower extremities, chronic venous compartment syndrome (CVCS) develops, which is fundamentally different from previously known clinical pictures. Progressive dermatolipofasciosclerosis and cicatricial destruction of the fascia of the leg in patients with C4b-C6 clinical classes according to CEAP affect the pressure in the muscle-fascial compartments at each step. In severe cases, this leads to significant changes in the muscles, accompanied by chronic ischemia associated with necrosis and glycogen deficiency. The analysis of various diagnostic methods, conservative treatment and methods for performing surgical decompression of the CCS was carried out. The lack of a clear pathophysiology for CECS and CVCS complicates the diagnosis and treatment of this condition. Diagnosis of calf CCS is still based on pressure testing in the musculofascial compartments of the calf using the Pedowitz criteria, however standard procedures for this, including patient position, static or dynamic movements, muscles and equipment tested, are not agreed upon. In patients with CCS, if conservative treatment is ineffective, fasciotomy of the affected parts of the lower leg is the method of choice. Various techniques for fasciotomy of the lower leg include the traditional open fasciotomy, the semi-closed technique with one or more incisions, the minimally invasive technique using endoscopic compartment release, and the use of ultrasound guidance. Fasciectomy of the lower leg to correct CVCS is performed mainly for recurrence of trophic ulcers after shave therapy, severe calcification of the lower leg tissues and for the treatment of deep transfascial necrosis. Randomized, blinded, controlled trials are needed to further expand our knowledge of the diagnosis and treatment of CCS.

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Section: флебологияunclassified

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Katorkin

Kushnarchuk

2023

Ambulatornaya khirurgiya

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“…Eradication of superficial reflux with additional subcutaneous fasciotomy for chronic and recurrent venous ulcer improves ulcer healing and even success rates of skin grafting. [20] Endovenous ablation alone has also reported reduced ulcer recurrence. [21] Among the various causes of recurrence, incompetent perforators in calf, primary or secondary deep vein insufficiency and incorrectly treated saphenous veins are most encountered causes.…”

Section: Venous Surgerymentioning

confidence: 99%

Prevention of venous leg ulcer recurrence

Shenoy¹

2014

Indian Dermatol Online J

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“…IMP measurement was performed in the three deep compartments of the leg: soleus, gastrocnemius, and anterior tibial. The leggings had no effect on IMP during walking and running, but there was a significant increase in IMP in the standing position for low IPs (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The main limitation, however, of Murthy's results was their improper use of Circaid Õ devices which, in our opinion, were applied too loosely in their study.…”

Section: For the Future: A Numerical Approach And Simulation By Finitmentioning

confidence: 99%

“…In fact, variations of IMP based on CVI have been shown by Christenson and coworkers. 23,24 Subcutaneous pressures increase from 8 to 16 mmHg and from 12 to 34 mmHg for IMP with CVI severity with the highest pressures being for severe obstructive syndromes. In healthy subjects, subcutaneous tissue pressure is very low, less than 5 mmHg.…”

Section: Limitations Of the Three-dimensional Mri Modeling Of The Calfmentioning

confidence: 99%

Relationship between medical compression and intramuscular pressure as an explanation of a compression paradox

Cornu‐Thénard

Fournier³

et al. 2014

Phlebology

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We found that an IP of 22 mmHg produced a significant IMP increase from 32 to 54 mmHg, in the standing position. At the same time, the subcutaneous pressure is only provided by the compression device, on healthy subjects. In other words, the subcutaneous pressure plus the IP is only a little higher than 22 mmHg-a pressure which is too low to reduce the caliber of the superficial veins. This is in accordance with our standing MRI 3D anatomical study which showed that, paradoxically, when applying low pressures (IP), the deep veins are compressed while the superficial veins are not.

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Subcutaneous fasciotomy and eradication of superficial venous reflux for chronic and recurrent venous ulcers: mid-term results

Cited by 12 publications

References 20 publications

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Chronic compartment-syndrome of the lower limb: modern strategies for diagnosis and treatment

Prevention of venous leg ulcer recurrence

Relationship between medical compression and intramuscular pressure as an explanation of a compression paradox

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