scholarly journals Study on the efficacy of surgery of the superficial venous system and of compression therapy at early stages of chronic venous disease for the prevention of chronic venous ulceration

2016 ◽  
Vol 13 (6) ◽  
pp. 1385-1388 ◽  
Author(s):  
Raffaele Serra ◽  
Bruno Amato ◽  
Lucia Butrico ◽  
Andrea Barbetta ◽  
Giovanni De Caridi ◽  
...  
Keyword(s):  
Compression Therapy ◽  
Venous System ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Early Stages

Venous Stasis Disease

2019 ◽  
Author(s):  
Allyson R Alfonso ◽  
Daniel Cuzzone ◽  
Ernest S Chiu
Keyword(s):  
Venous Insufficiency ◽  
Compression Therapy ◽  
Venous Ulcer ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Disease Etiology ◽  
Venous Clinical Severity Score

Chronic venous disease (CVD) is a chronic and morbid condition with a wide pathologic spectrum. The common denominator is either impaired venous outflow or anomalous (retrograde) venous inflow most often related to a failure of the valvular system. Diagnosis is made with a thorough history, physical examination, and imaging such as duplex ultrasonography. The disease can then be classified using the Clinical, Etiology, Anatomic, Pathophysiology classification system and Venous Clinical Severity Score. Management is based on disease etiology and symptomatic presentation. It is important to first identify the presence or absence of venous ulceration. In venous ulceration, compression therapy with contact dressings is standard therapy, but surgical wound debridement and skin or fat grafting can be necessary for wound closure. Additional operative treatment for those with CVD can include conservative hemodynamic correction of venous insufficiency, vein stripping, and endovenous thermal ablation. With multiple etiologies and subsequent treatment options, CVD requires patient and vigilant care on part of the patient and the treating clinician. Although much is known about CVD, our ability to predict, prevent, and treat is limited by aspects of the disease in need of further study.   This review contains 8 figures, 6 tables, and 51 references. Key Words: chronic venous disease, chronic venous insufficiency, venous ulcer, wound healing, venous physiology, venous ulcer management, compression therapy, wound contact dressings, surgical management 

scholarly journals Why Venous Leg Ulcers Have Difficulty Healing: Overview on Pathophysiology, Clinical Consequences, and Treatment

2020 ◽  
Vol 10 (1) ◽  
pp. 29
Author(s):  
Joseph D. Raffetto ◽  
Daniela Ligi ◽  
Rosanna Maniscalco ◽  
Raouf A. Khalil ◽  
Ferdinando Mannello
Keyword(s):  
Endothelial Cell ◽  
Reactive Oxygen ◽  
Compression Therapy ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Nitrogen Species ◽  
Venous Leg Ulcers ◽  
Tissue Metabolites

Venous leg ulcers (VLUs) are one of the most common ulcers of the lower extremity. VLU affects many individuals worldwide, could pose a significant socioeconomic burden to the healthcare system, and has major psychological and physical impacts on the affected individual. VLU often occurs in association with post-thrombotic syndrome, advanced chronic venous disease, varicose veins, and venous hypertension. Several demographic, genetic, and environmental factors could trigger chronic venous disease with venous dilation, incompetent valves, venous reflux, and venous hypertension. Endothelial cell injury and changes in the glycocalyx, venous shear-stress, and adhesion molecules could be initiating events in VLU. Increased endothelial cell permeability and leukocyte infiltration, and increases in inflammatory cytokines, matrix metalloproteinases (MMPs), reactive oxygen and nitrogen species, iron deposition, and tissue metabolites also contribute to the pathogenesis of VLU. Treatment of VLU includes compression therapy and endovenous ablation to occlude the axial reflux. Other interventional approaches such as subfascial endoscopic perforator surgery and iliac venous stent have shown mixed results. With good wound care and compression therapy, VLU usually heals within 6 months. VLU healing involves orchestrated processes including hemostasis, inflammation, proliferation, and remodeling and the contribution of different cells including leukocytes, platelets, fibroblasts, vascular smooth muscle cells, endothelial cells, and keratinocytes as well as the release of various biomolecules including transforming growth factor-β, cytokines, chemokines, MMPs, tissue inhibitors of MMPs (TIMPs), elastase, urokinase plasminogen activator, fibrin, collagen, and albumin. Alterations in any of these physiological wound closure processes could delay VLU healing. Also, these histological and soluble biomarkers can be used for VLU diagnosis and assessment of its progression, responsiveness to healing, and prognosis. If not treated adequately, VLU could progress to non-healed or granulating VLU, causing physical immobility, reduced quality of life, cellulitis, severe infections, osteomyelitis, and neoplastic transformation. Recalcitrant VLU shows prolonged healing time with advanced age, obesity, nutritional deficiencies, colder temperature, preexisting venous disease, deep venous thrombosis, and larger wound area. VLU also has a high, 50–70% recurrence rate, likely due to noncompliance with compression therapy, failure of surgical procedures, incorrect ulcer diagnosis, progression of venous disease, and poorly understood pathophysiology. Understanding the molecular pathways underlying VLU has led to new lines of therapy with significant promise including biologics such as bilayer living skin construct, fibroblast derivatives, and extracellular matrices and non-biologic products such as poly-N-acetyl glucosamine, human placental membranes amnion/chorion allografts, ACT1 peptide inhibitor of connexin 43, sulodexide, growth factors, silver dressings, MMP inhibitors, and modulators of reactive oxygen and nitrogen species, the immune response and tissue metabolites. Preventive measures including compression therapy and venotonics could also reduce the risk of progression to chronic venous insufficiency and VLU in susceptible individuals.

Update on Chronic-Venous-Insufficiency-Induced Inflammatory Processes

Angiology ◽  
2001 ◽  
Vol 52 (1_suppl) ◽  
pp. S35-S42 ◽  
Author(s):  
Philip D. Coleridge Smith
Keyword(s):  
Growth Factor ◽  
Ischemia Reperfusion ◽  
Tissue Hypoxia ◽  
Chronic Venous Disease ◽  
Tissue Inhibitors Of Metalloproteinases ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Transcutaneous Oxygen ◽  
Sequence Of Events ◽  
Inflammatory Processes

The causes of venous ulceration remain unclear. Twentieth-century hypotheses concentrated on the possibility that this problem was caused by failure of oxygen delivery to the skin. However, it has been difficult to substantiate these predictions in practice. Although the presence of tissue hypoxia has been suggested by studies in which transcutaneous oxygen tension has been assessed with transducers heated to unphysiological temperatures, when oxygen measurements are made at room temperature there is little evidence of tissue hypoxia. This has led to the assessment of alternative mechanisms of ulcer development. There has been considerable interest in recent years in the inflammatory processes that surround venous ulceration. A complex sequence of events appears to surround the develop ment of leg ulceration. Increased leukocyte activation has been shown in patients with venous disease as well as increased expression of soluble endothelial adhesion molecules. Histologic studies of the skin in patients with chronic venous disease show a perivascular infiltration of the capillaries of the papillary plexus (the most superficial part of the dermis) with monocytes, macrophages, and connective tissue proteins including fibrin. Fibrosis of the skin and subcutaneous tissues may be initiated by increased gene expression and production of transforming growth factor-β 1. Vascular endothelial growth factor may be involved in the capillary proliferation that has been reported in the skin by a number of authors. Increased expression of several tissue metallo proteinases has been reported both in liposclerotic skin and periulcer skin. The tissue inhibitors of metalloproteinases are also increased and the net result is unclear. Treatment of venous disease using micronized purified flavonoid fraction moderates some of the inflammatory markers, including leukocyte ligand expression and endothelial adhesion molecule shedding. These compounds have also been shown to reduce leukocyte-endothelial adhesion in animal models of ischemia-reperfusion injury. Many inflammatory processes have now been shown to be involved in the development of the skin changes in patients with chronic venous disease. However, the precise sequence of events that leads to leg ulceration is still unclear. Pharmacologic treatments aimed at moderating some of these inflammatory processes are now under investigation as potential ways of treating patients with the more advanced stages of venous disease.

Initiating compression therapy for those living with heart failure

2021 ◽  
Vol 26 (Sup9) ◽  
pp. S12-S17
Author(s):  
Dumitriu Saucedo ◽  
Nicholas Evans ◽  
Chung Sim Lim
Keyword(s):  
Heart Failure ◽  
Compression Therapy ◽  
Decompensated Heart Failure ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Evidence Based ◽  
Patients With Heart Failure ◽  
Precautionary Measures ◽  
Evidence Based Guideline ◽  
Nursing Professionals

Compression therapy is used to treat leg symptoms arising from chronic venous disease and lymphoedema. Heart failure, which is traditionally regarded as a contraindication for compression therapy, is prevalent among patients with such leg symptoms. This article aims to assess the evidence on the safety and effectiveness of compression therapy, as well as recommending the assessment and measures required when initiating compression therapy in patients with heart failure. Recent evidence suggests that initiating compression therapy in patients with stable and compensated heart failure is safe if appropriate precautionary measures are undertaken. However, there is still insufficient evidence to support the safety of compression therapy in patients with severe and decompensated heart failure. A standardised, evidence-based guideline on compression therapy in patients with heart failure will help medical and nursing professionals and improve informed consent for the patients.

The impact of compression garments on the quality of life in patients with chronic venous disease

Physiotherapy ◽  
2017 ◽  
Vol 24 (2) ◽  
Author(s):  
Iwona Demczyszak ◽  
Edyta Sutkowska ◽  
Magdalena Jasiak ◽  
Małgorzata Fortuna ◽  
Justyna Mazurek
Keyword(s):  
Quality Of Life ◽  
Lower Extremity ◽  
Compression Therapy ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Garments ◽  
Before And After ◽  
The Impact ◽  
Career Status

AbstractIntroduction. Assessment of quality of life in patients suffering from chronic venous disease of the lower extremity who were treated with compression garments. Methods. Patients of both sexes aged 30-75 years with chronic venous disease and at least varices, but without active ulceration, were qualified for the study. To assess the quality of life, the CIVIQ-20 questionnaire was used before and after 4 weeks of compression therapy with second class compression. Results. The combined results of the CIVIQ scale rose from 61.49% before compression to 75.17% after 4 weeks of compression therapy (p 0.01). No correlation was found between sex, age, career status or type of work and the averaged CIVIQ score. Conclusions. Compression therapy with special garments significantly improves the quality of life in patients with chronic venous disease. Larger studies are still needed in this field.

A Novel Scoring System for Lower-extremity Venous Pathology Analysed Using Magnetic Resonance Venography and Duplex Ultrasound

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 163-170 ◽  
Author(s):  
C W K P Arnoldussen ◽  
I Toonder ◽  
C H A Wittens
Keyword(s):  
Magnetic Resonance ◽  
Lower Extremity ◽  
Scoring System ◽  
Imaging Techniques ◽  
Vena Cava ◽  
Duplex Ultrasound ◽  
Venous System ◽  
Magnetic Resonance Venography ◽  
Chronic Venous Disease ◽  
Venous Disease

Objectives: To present a novel scoring system for lower-extremity venous pathology (the LOVE score) and our experiences using it in our clinical practice to identify venous pathology with duplex ultrasound (DUS) and magnetic resonance venography (MRV). Method: A total of 40 patients, 30 suspected of chronic venous disease and 10 with acute deep vein thrombosis (DVT) were examined from the inferior vena cava (IVC) to the popliteal vein using DUS and MRV. The image findings were reported using the LOVE score. Results The majority of deep veins (368 out of 378 segments) were completely visualized by both our imaging techniques and could be analysed using the LOVE score. Both imaging techniques reported comparable findings with regard to the visualization of thrombus, obstruction, collaterals, trabeculations, anatomic variations and central venous compression (e.g. May–Thurner). Conclusions: The LOVE score can be used to expand and standardize the documentation of imaging the deep venous system beyond thrombosis, to help identify (optimal) treatment options in patients with venous disease, in both the clinical and research setting. This first assessment shows that both DUS and MRV are capable of systematically identifying a multitude of changes in the venous system.

scholarly journals Circaid adjustable inelastic compression wraps for the treatment of lower limb edema in the venous system pathology

2019 ◽  
pp. 12-16
Author(s):  
A. Yu. Semenov ◽  
A. M. Malakhov
Keyword(s):  
Chronic Venous Insufficiency ◽  
Western Europe ◽  
Venous Insufficiency ◽  
Medical Science ◽  
Compression Therapy ◽  
European Population ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Garments ◽  
The Usa

Symptoms of chronic venous insufficiency have been known since antiquity. The prevalence of chronic venous insufficiency in Western Europe and the USA has been reported within the range from from 1 to 40% in women and from 1 to 17% in men [1]. As reported by the European authors, the average prevalence of chronic venous insufficiency with class C2-C6 (according to the CEAP classification) among the European population reaches 30% [2]. Edema syndrome remains one of the leading manifestations of chronic venous disease. Compression therapy is one of the main ways to combat edema. The arsenal of devices for the treatment of edematous syndrome is steadily expanding with the development of medical science. Today, in addition to inelastic compression wrap and elastic compression garments, brand-new compression products, circaid adjustable inelastic compression wraps are available.

The Contribution of Nutrition in Compression Therapy for Chronic Venous Disease

2020 ◽  
Vol 7 (3) ◽  
pp. 09-12
Author(s):  
Hendro Sudjono Yuwono ◽  
Dedy Pratama
Keyword(s):  
Mechanical Treatment ◽  
Pathological Change ◽  
Compression Therapy ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Essential Step ◽  
Nutrition Intake ◽  
Mechanical Therapy

Compression therapy is an essential step for the treatment of chronic venous disease (CVD). It is a mechanical treatment against the venous wall's persistent pathological change and the CVD created by inner metabolic substances that damage the wall and valves. The damage is possible to prevent using flavonoid drug and daily nutrition intake, which support the mechanical therapy positively.

scholarly journals The effect of compression therapy on quality of life in patients with chronic venous disease: a comparative 6-month study

2020 ◽  
Author(s):  
Andrzej Berszakiewicz ◽  
Janusz Kasperczyk ◽  
Aleksander Sieroń ◽  
Zbigniew Krasiński ◽  
Armand Cholewka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Compression Therapy ◽  
Chronic Venous Disease ◽  
Venous Disease
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