The role of compression therapy
in the treatment of venous leg ulcers

Mościcka, Paulina; Szewczyk, Maria T.; Cwajda‐Białasik, Justyna; Jawień, Arkadiusz

doi:10.17219/acem/78768

Cited by 44 publications

(59 citation statements)

References 28 publications

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“…29 In many studies, it has been proved that in small area (<5 cm 2 ) and short-time ulcers (less than six months) 95% are curable in less than 24 weeks, while much more time to close the extensive ulcer is required. 3 In our study, the 2.5-year-old ulcer with the area of about 20 cm 2 was completely healed and a scab with the area of about 5 cm 2 appeared within four weeks without the use of antibiotics. It would seem that the key to success was not only the use of inelastic multicomponent bandages with proven effectiveness, but above all frequent bandage renewal in the first week of therapy and constant sub-bandage pressure control using the Kikuhime device.…”

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

“…1 All information about past and present medical conditions of the patient, physical examination, laboratory testing, or hemodynamic evaluation may help clinicians to determine a diagnosis as well as a type of leg ulceration and its cause. 3 This last medical tool allows us to assess arterial supply to leg by determining the Ankle-brachial Pressure Index (ABPI) using Duplex ultrasound. 4 Different endovenous interventions such as endovenous ablation of superficial reflux, thermal ablation and foam sclerotherapy are universally acknowledged techniques for reducing healing time of leg ulcers and increasing ulcer-free time.…”

Section: Introductionmentioning

confidence: 99%

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<p>Kikuhime Device in the Management of Venous Leg Ulcers</p>

Karafa¹,

Karafova²

2020

CIA

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The effectiveness of compression therapy in the treatment of venous leg ulcers has been confirmed in many scientific studies. The healing process depends on many of its parameters, such as the type of compression bandages, their elastic properties and subbandage pressure. However, there is no standard protocol that would ensure success for all patients. A pressure of about 83 mmHg provides complete compression for both superficial and deep veins; however, applying compression bandages under such high pressure is a difficult task, even for experienced therapists. Here, we present the case of a 61-year-old woman with approximately 2.5-year-old venous ulcer in her left leg due to chronic venous insufficiency (CVI). Our study aimed to show that routine pressure control at each bandage renewal using the Kikuhime device, as well as their twice daily application in the first week of therapy reduced the healing time of a venous leg ulcer with an area of about 20 cm 2 to four weeks.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Kikuhime Device in the Management of Venous Leg Ulcers</p>

Karafa¹,

Karafova²

2020

CIA

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“…Despite differences, chronic wounds have some common characteristics, e.g., increased levels of growth factors that can control cell migration, enzyme expression, and differentiation, proinflammatory cytokines that can regulate cell activity and functions [ 4 ], as well as reactive oxygen species (ROS) that have both defensive and signalling roles [ 3 ]. In local wound treatment, the TIME strategy developed by the European Wound Management Association is used, which contributes to the stimulation of natural healing mechanisms and includes: T—tissue debridement, I—infection and inflammation control, M—moisture balance, and E—epidermisation stimulation [ 5 ]. More advanced therapies, such as topical platelet-derived growth factor (PDGF), negative-pressure wound therapy, or bioengineered cell-containing therapies [ 6 ], are used to treat wounds that do not improve over a few weeks.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Oxidative Stress in Patients with Difficult-to-Heal Skin Wounds Treated with Hyperbaric Oxygen

Paprocki

Pawłowska

Sutkowy

et al. 2020

Oxidative Medicine and Cellular Longevity

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Objective. To determine the concentration of thiobarbituric acid reactive substances (TBARS) in erythrocytes and blood plasma, and the activities of selected antioxidant enzymes: catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in erythrocytes in patients receiving hyperbaric oxygen (HBO) treatment due to difficult-to-heal “skin wounds”. Material and Methods. Indices of oxidative stress were assessed in venous blood taken from 23 patients three times: immediately before HBO procedure, approx. 5 minutes after leaving the hyperbaric chamber, and after 25 HBO procedures. Moreover, selected blood counts were measured in the collected material two times: prior to treatment and after 25 HBO procedures. Results. A statistically significant positive correlation between the CAT activity and the TBARS concentration in the erythrocytes of patients was found before treatment in the hyperbaric chamber (r=0.394; P≤0.05). No statistically significant changes in the TBARS concentration in erythrocytes and blood plasma were observed both after the first HBO procedure and after 25 procedures. No statistically significant changes in the activities of CAT, SOD, and GPx were noted. Platelet count decreased by 18.7% (P≤0.05) after 25 HBO procedures. Granulocyte count decreased by approx. 21% (P≤0.05), and granulocyte percentage by 11.8% (P≤0.01). In turn, the percentage of lymphocytes and monocytes increased after the treatment by 16.6% (P<0.05) and 16.4% (P<0.05), respectively. Conclusions. Exposure to HBO due to difficult-to-heal skin wounds does not significantly affect the levels of oxidative stress in the peripheral blood of patients and, from the point of view of oxidation–reduction processes, appears to be a safe therapeutic method for the treatment of chronic wounds.

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“…The diversity of the treatment depending on the ulcers’ etiology makes it necessary to know their pathophysiological process and the physical laws that condition them. This knowledge will allow to choose between the treatment options, both preventive and healing, for a more effective approach [ 11 ]. A relationship between the laws of physics and pathophysiological processes together with their consequent nursing care has already been showed.…”

Section: Introductionmentioning

confidence: 99%

The Physics of Fluid Dynamics Applied to Vascular Ulcers and Its Impact on Nursing Care

et al. 2020

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The high incidence of vascular ulcers and the difficulties encountered in their healing process require the understanding of their multiple etiologies to develop effective strategies focused on providing different treatment options. This work provides a description of the principles of the physics of fluid dynamics related to vascular ulcers. The morphological characteristics of the cardiovascular system promote blood flow. The contraction force of the left ventricle is enhanced by its ability to reduce its radius of curvature and by increasing the thickness of the ventricular wall (Laplace’s Law). Arterial flow must overcome vascular resistance (Ohm’s equation). The elastic nature of the artery and the ability to reduce its diameter as flow rate progresses facilitate blood conduction at high speed up to arteriolar level, and this can be determined by the second equation of continuity. As it is a viscous fluid, we must discuss laminar flow, calculated by the Reynolds number, which favors proper conduction while aiming at the correct net filtration pressure. Any endothelial harmful process that affects the muscle wall of the vessel increases the flow speed, causing a decrease in capillary hydrostatic pressure, thus reducing the exchange of nutrients at the interstitial level. With regard to the return system, the flow direction is anti-gravity and requires endogenous aid to establish the Starling’s equilibrium. Knowledge on the physics of vascular fluid dynamics makes it easier to understand the processes of formation of these ulcers so as to choosing the optimal healing and prevention techniques for these chronic wounds.

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The role of compression therapy in the treatment of venous leg ulcers

Cited by 44 publications

References 28 publications

<p>Kikuhime Device in the Management of Venous Leg Ulcers</p>

<p>Kikuhime Device in the Management of Venous Leg Ulcers</p>

Evaluation of Oxidative Stress in Patients with Difficult-to-Heal Skin Wounds Treated with Hyperbaric Oxygen

The Physics of Fluid Dynamics Applied to Vascular Ulcers and Its Impact on Nursing Care

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