What's new: Management of venous leg ulcers

Alavi, Afsáneh; Sibbald, R. Gary; Phillips, Tania J.; Miller, O. Fred; Margolis, David J.; Marston, William A.; Woo, Kevin; Romanelli, Marco; Kirsner, Robert S.

doi:10.1016/j.jaad.2015.03.059

Cited by 105 publications

(96 citation statements)

References 136 publications

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“…Venous leg ulcers are the most severe manifestations of chronic venous disease, a condition caused by venous hypertension when valvular incompetence or venous outflow obstruction leads to impaired venous return 91011. Factors affecting the calf muscle pump function, including poor mobility, also result in venous stasis 91213…”

Section: What Is the Pathophysiology Of Venous Leg Ulcers?mentioning

confidence: 99%

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Diagnosis and management of venous leg ulcers

Lim

Baruah²,

Bahia

2018

BMJ

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Section: What Is the Pathophysiology Of Venous Leg Ulcers?mentioning

confidence: 99%

“…Between 30% and 75% of venous leg ulcers will heal after six months of compression therapy 91011. High quality evidence from randomised controlled trials suggests that multicomponent compression bandages (fig 4) provide a sustained sub-layer pressure of 35-40 mm Hg that will heal most venous leg ulcers 193438…”

Section: How To Treat Venous Leg Ulcers?mentioning

confidence: 99%

Diagnosis and management of venous leg ulcers

Lim

Baruah²,

Bahia

2018

BMJ

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“…Compression therapy is a challenge in these patients because of lower leg tenderness. In a study from the United Kingdom, the two main reasons for non‐adherence in these patients included discomfort and difficulty in putting on the compression garments . The effectiveness of compression therapy is also minimal, but it is beneficial for the associated oedema in these patients through the reduction in interstitial fluid.…”

Section: Treatmentmentioning

confidence: 99%

Lipoedema is not lymphoedema: A review of current literature

Shavit

Wollina

Alavi

2018

International Wound Journal

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Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long-lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.

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“…After making contact with exudates, the polymer forms a gel to promote rehydration in wounds with many exudates, thereby enhancing autolytic debridement (Dabiri et al, ). Alginate adjuvant contains calcium salts and sodium salts of alginic acid, and the soluble calcium–sodium alginate is produced after alginate dressing has been applied to a moist leg wound to maintain the moist environment and promotes autolytic debridement (Alavi et al, ). Cutimed, Tegaderm Biatain, and Kaltostat are commercially available alginate dressings that conform to the shape of a wound to avoid the occurrence of periwound skin and delayed healing.…”

Section: Polymer‐based Functional Wound Dressings For Treating CVImentioning

confidence: 99%

“…Bioactive wound dressings generally comprise antimicrobial dressings (Alavi et al, ; Marston, Tang, Kirsner, & Ennis, ), drug‐released dressings (Jull et al, ; Stana et al, ), and nutrition‐providing dressings (Ray & Kalia, ). Recently, Hussain et al systematically reviewed and reported a number of convincing evidences for bioactive materials embedded polymer‐based chronic wound healing modalities, as well as the latest and innovative therapeutic strategies for management of chronic nonhealing wounds (Hussain, Thu, Shuid, Katas, & Hussain, ; Shao et al, ).…”

Section: Polymer‐based Functional Wound Dressings For Treating CVImentioning

confidence: 99%

Therapeutic compression materials and wound dressings for chronic venous insufficiency: A comprehensive review

Liu

Lao

2019

J Biomed Mater Res

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Chronic venous insufficiency (CVI) is a common disorder worldwide. Related pathophysiological mechanisms reportedly involve venous pooling and reduced venous return, leading to heaviness, aching, itchiness, tiredness, varicosities, pigmentation, and even lower limb ulceration. Approaches adopted to manage CVI at various stages of clinical‐etiology‐anatomy‐pathophysiology include compression therapy, pharmacological treatment, ultrasound treatment, surgery, electrical or wireless microcurrent stimulation, and pulsed electromagnetic treatment. Among these, polymer‐based therapeutic compression materials and wound dressings play increasingly key roles in treating all stages of CVI because of their unique physical, mechanical, chemical, and biological functions. However, the characteristics, working mechanisms, and effectiveness of these CVI treatment materials are not comprehensively understood. The present systematic review examines the structures, properties, types, and applications of various polymer‐based compression materials and wound dressings used in prophylaxis and treatment of CVI. Existing problems, limitations, and future trends of CVI treatment materials are also discussed. This review could contribute to the design and application of new functional polymer materials and dressings to enhance the efficiency of CVI treatments, thereby facilitating patients' self‐care ability and long‐term health improvement.

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What's new: Management of venous leg ulcers

Cited by 105 publications

References 136 publications

Diagnosis and management of venous leg ulcers

Diagnosis and management of venous leg ulcers

Lipoedema is not lymphoedema: A review of current literature

Therapeutic compression materials and wound dressings for chronic venous insufficiency: A comprehensive review

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