The Role of Compression Therapy in the Management of Lymphoedema

2008 ◽  
pp. 111-130 ◽  
Keyword(s):  
Compression Therapy

scholarly journals Compression therapy following ClariVein® ablation therapy: a randomised controlled trial of COMpression Therapy Following MechanO-Chemical Ablation (COMMOCA)

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Doireann P. Joyce ◽  
Stewart R. Walsh ◽  
Charyl J. Q. Yap ◽  
Tze T. Chong ◽  
Tjun Y. Tang
Keyword(s):  
Guideline Development ◽  
Varicose Veins ◽  
Controlled Trial ◽  
Clinical Excellence ◽  
Compression Therapy ◽  
Ablation Therapy ◽  
Compression Bandaging ◽  
Post Procedure ◽  
Chemical Ablation

Abstract Background Endovenous treatment of varicose veins has increased in popularity over the last decade. There remains, however, a degree of uncertainty regarding the role of compression bandaging or hosiery following this intervention. The National Institute for Clinical Excellence Guideline Development Group has advocated further research to evaluate the clinical and cost-effectiveness of this post-procedure intervention. In addition to this, the duration of compression bandaging also warrants clarification. Methods Ethical approval for the study was obtained from the Singhealth Centralised Institutional Review Board (CIRB Ref: 2017/2710). Consent to enter the study will be sought from each participant only after a full explanation has been given, an information leaflet offered and time allowed for consideration. Signed participant consent will be obtained. Patients will be randomised to either compression (group A) or no compression (group B). The primary aim of the study is to assess the patient’s pain scores for the first 10 days post procedure using a visual analogue scale. Secondary aims include an assessment of patient compliance with compression, quality of life scores, clinical effectiveness, rates of bruising and phlebitis, time taken to return to normal activities, patient satisfaction and occlusion rate at 6 months. Discussion The purpose of this study is to examine the effect of compression therapy in patients having mechano-chemical ablation (MOCA) therapy for truncal incompetence of their varicose veins using the ClariVein® device. This study may provide clarification on the role of compression therapy in patients undergoing MOCA. Trial registration ClinicalTrials.gov, NCT03685838. Registered on 26 September 2018.

ROLE OF PHENERGAN IN ABNORMAL SCARS AND KELOIDS

2004 ◽  
Vol 12 (04) ◽  
pp. 471-482
Author(s):  
J. VENUGOPAL ◽  
V. JAYARAMAN ◽  
MARY BABU ◽  
S. RAMAKRISHNA
Keyword(s):  
Dna Synthesis ◽  
Hypertrophic Scar ◽  
Skin Fibroblast ◽  
Collagen Synthesis ◽  
Normal Skin ◽  
Compression Therapy ◽  
Matrix Proteins ◽  
Intralesional Corticosteroid ◽  
Normal Skin Fibroblast

Hypertrophic scar and keloids have affected patients and frustrated physicians for centuries. Hypertrophic scar (HSc) and keloids are a major problem for patients who survive extensive thermal and traumatic skin injuries. HSc and other fibroproliferative disorders are associated with excessive accumulation of collagen and extracellular matrix proteins due to an imbalance between synthesis and degradation. The therapeutic management of hypertrophic scars and keloids include occlusive dressings, compression therapy, intralesional corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon therapy and other promising lesser known therapies directed at collagen synthesis. In this study we investigated the effect of phenergan (promethazine hydrochloride) as one of the most potent histamine antagonists on cell proliferation, DNA synthesis and collagen production in fibroblast isolated from human post burn hypertrophic scar, keloids and normal skin. The proliferation of normal skin fibroblast was slightly decreased but hypertrophic scar and keloids showed significant (p<0.001) level of decrease after 72 hours of phenergan (750 μM) treatment. The results of DNA synthesis also significantly (p<0.001) decreased in hypertrophic scar and keloid fibroblasts. Phenergan (1.5 mM) decreased the collagen synthesis upto 61% and 66% in HSc and keloids in comparison to normal skin fibroblast, which showed reduction of 38% after 72 hours. Improved understanding of such regulatory mechanisms may eventually be of therapeutic significance in the control of hypertrophic scar and keloids.

scholarly journals Role of Four Layer Compression Dressings in Management of Chronic Venous Ulcers

2019 ◽  
Vol 5 (02) ◽  
pp. 42-45
Author(s):  
Luv Luthra ◽  
Rajendra Prasad ◽  
Ranjith Kumar ◽  
Nivedita Mitta ◽  
Tinku Varghese
Keyword(s):  
Lower Extremity ◽  
Healing Rate ◽  
Randomized Study ◽  
Compression Therapy ◽  
High Morbidity ◽  
Age Group ◽  
Duration Of Treatment ◽  
Medical College ◽  
Venous Ulcers

Abstract Introduction Nonhealing venous ulcers are one of the most common forms of lower extremity ulcers in the present population. It is cumbersome to treat and is associated with high-morbidity and immense treatment expenses. The current treatments include compression therapy. Four-layer compression dressings have proven to be an effective treatment for venous ulcers. Objective This study aimed to evaluate the efficacy of four-layer compression dressings and to study the rate of healing and duration of treatment with four-layer compression dressings. Materials and Methods A prospective randomized study conducted at MS Ramaiah Medical college which included 70 patients who completed the course of weekly dressings depending on the size of ulcer. The regular four-layer dressings were done by a trained podiatrist in vascular outpatient department (OPD) once a week. The area of the ulcer was calculated using the modified Gilmen formula. Results A total of 70 patients who were compliant with the treatment were included in the study. A considerable percentage (74%) of patients were male and all the ulcers were located at the gaiter area. Most belonged to the age group between 41 to 50 years (25%). The healing rate of ulcers at the end of 4, 8 and 12 weeks were 46.87, 28.12, and 25%, respectively. At the end of 12 weeks, all the ulcers healed.

scholarly journals Przewlekłe leczenie przeciwkrzepliwe

2018 ◽  
Vol 49 (2) ◽  
pp. 47-49 ◽  
Author(s):  
Krystyna Zawilska
Keyword(s):  
Pulmonary Embolism ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Compression Therapy ◽  
Good Choice ◽  
Anticoagulant Treatment ◽  
Efficacy And Safety ◽  
Risk Of Bleeding

AbstractUnprovoked venous thromboembolism (VTE) - proximal venous thrombosis or pulmonary embolism - should be treated either 3 months or indefinitely if the risk of bleeding is low. This article summarizes the efficacy and safety of extended therapy of VTE with direct oral anticoagulants (DOAC) in comparison with warfarin, as well as the role of of acetylsalicylic acid (ASA) for the long-term prevention of recurrent VTE. As the Survet study showed, for some patients who have already completed at least 6 months of anticoagulant treatment for their index VTE event, an oral glycosaminoglycan - sulodexide associated with compression therapy is a good choice, because it decreases the incidence of recurrences of VTE without detectable risks for the patients’ safety.

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

2018 ◽  
Vol 28 (6) ◽  
pp. 847-852 ◽  
Author(s):  
Paulina Mościcka ◽  
Maria Szewczyk ◽  
Justyna Cwajda-Białasik ◽  
Arkadiusz Jawień
Keyword(s):  
Compression Therapy ◽  
Leg Ulcers ◽  
Venous Leg Ulcers

Wound dressings, does it matter and why?

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 63-67 ◽  
Author(s):  
Marjolein Birgitte Maessen-Visch ◽  
Catherine van Montfrans
Keyword(s):  
Cochrane Review ◽  
Standard Of Care ◽  
Compression Therapy ◽  
Wound Dressings ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Compression Bandages ◽  
Wide Range ◽  
The Cost

Compression therapy and treating venous insufficiency is the standard of care for venous leg ulcers. The need for debridement on healing venous leg ulcers is still debated. Dressings are often used under compression bandages to promote faster healing and prevent adherence of the bandage to the ulcer. A wide range of dressings is available, including modern dressings with different kinds of biological activity. Microbial burden is believed to underlie delayed healing, but the exact role of microbiofilm in wound healing is uncertain. Before choosing a specific wound dressing, four main functions should be considered: (1) cleaning, (2) absorbing, (3) regulating or (4) the necessity of adding medication. There is no clear evidence to support the use of one dressing over another, as demonstrated by many Cochrane review studies. In addition, the prescriber should enquire about contact allergies that may also develop during wound treatment. It is shown that early intervention and early investment may reduce the cost of treatment. The choice of wound dressings should be guided by cost, ease of application and patient and physician preference and be part of the complete strategy. The role of the medical specialist is evident. Wound dressings matter as part of the optimal treatment in VLU patients.

Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF)

2017 ◽  
Vol 32 (1_suppl) ◽  
pp. 3-19 ◽  
Author(s):  
Ronald Bush ◽  
Anthony Comerota ◽  
Mark Meissner ◽  
Joseph D. Raffetto ◽  
Steven R. Hahn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Management ◽  
Compression Therapy ◽  
Chronic Venous Disease ◽  
General Level ◽  
Venous Disease ◽  
Level Of Evidence ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction

Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema. An initial search of Medline, Cochrane Database for Systematic Reviews and Google Scholar databases was conducted. The references of articles obtained in the primary search, including a Cochrane review of phlebotonics for venous insufficiency, were reviewed for additional studies. Studies were included if patients had a diagnosis of chronic venous disease documented with Doppler and Impedance Plethysmography. Studies excluded were those that had patients with arterial insufficiency (Ankle Brachial Index < .6), comorbidity of diabetes, obesity, rheumatological diseases, or if other causes of edema were present (congestive heart failure, renal, hepatic or lymphatic cause), or if the patient population had recent surgery or deep vein thrombosis, or had been using diuretics (in studies of edema). Other elements of the study design were to note specifically the type of compression therapy used in conjunction with Micronized Purified Flavonoid Fraction. Results The literature review yielded 250 abstracts, 65 of which met criteria for further review and 10 papers were selected for consideration in the systematic review. Conclusion In summary, the general level of evidence supports the recommendation that the use of medical therapy with Micronized Purified Flavonoid Fraction has beneficial outcomes without serious adverse events. In the United States, diosmiplex is the only available prescription formulation of Micronized Purified Flavonoid Fraction. It is derived from the rinds of oranges and is categorized as a medical food and not as a drug; and may be a particularly attractive therapy for many chronic venous disease patients because of its favorable safety profile. The Working Group for chronic venous disease concurs with previous guidance by the International European Society for Vascular Surgery in 2015 which recommended the use of Micronized Purified Flavonoid Fraction for the healing of venous ulcers, alone and adjunctive to compression therapy, and for the reduction in symptoms of chronic venous disease such as edema.

Role of compression therapy in pathophysiology of the venous system in lower limbs

The Surgeon ◽  
2017 ◽  
Vol 15 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Adam Hague ◽  
Arun Pherwani ◽  
Sriram Rajagopalan
Keyword(s):  
Compression Therapy ◽  
Venous System ◽  
Lower Limbs
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