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Is chronic venous ulcer curable? A sample survey of a plastic surgeon.

Alamelu V - Indian J Plast Surg (2011)

Bottom Line: Remaining nineteen cases were given surgical modality in which fifteen cases (51.74%) were successful.Only seven cases (24.13%) failed to heal.Foot care, regular exercises and follow-up were stressed effectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College and Govt General Hospital, Chennai - 600 003; Sri Jayam Hospital, West Tambaram, Chennai - 600 045; K.J. Hospital and Research Foundation, Poonamallee High Road, Chennai - 600 084, India.

ABSTRACT

Introduction: Venous ulcers of lower limbs are often chronic and non-healing, many a time neglected by patients and their treating physicians as these ulcers mostly do not lead to amputation as in gangrenous arterial ulcer and also cost much to complete the course of treatment and prevention of recurrence.

Materials and methods: One hundred and twenty two lower limb venous ulcers came up for treatment between May 2006 and April 2009. Only twenty nine cases completed the treatment. The main tool of investigation was the non invasive Duplex scan venography. Biopsy of the ulcer was done for staging the disease. Patients' choice of treatment was always conservative and as out-patient instead of hospitalisation and surgery, which required a lot of motivation by the treating unit.

Results: Out of twenty nine cases, ten cases were treated conservatively and seven (24.13%) healed well. Remaining nineteen cases were given surgical modality in which fifteen cases (51.74%) were successful. Only seven cases (24.13%) failed to heal. Compression stockings were advised to control oedema, varices and pain. Foot care, regular exercises and follow-up were stressed effectively.

No MeSH data available.


Related in: MedlinePlus

Healing by collagen dressing
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Figure 3: Healing by collagen dressing

Mentions: All the 29 cases (25 males and 4 females) were initially treated with thorough cleaning and dressing. They were analysed as per Clinical findings, aetiology, anatomical site and pathological picture (CEAP classification)[9] for further management by either conservative or surgical modality. Ten cases (34.5%) with shallow, spreading ulcers having only superficial vein thrombosis were treated conservatively with saline or skin substitutes. We used locally available dressings like collagen sheet[10] in three patients [Figure 3], Quinidochlor cream with polyurethane foam dressing in three cases and nanocrystalline silver coated dressing[1112] in four cases. Out of these ten cases, seven cases (24.1% of total 29 cases) healed within 3 months of conservative treatment [Figure 3]. Compression stockings were given concurrently to the affected limb to reduce oedema, lymphostasis, pain and to enhance venous flow. Three cases failed to show healing.


Is chronic venous ulcer curable? A sample survey of a plastic surgeon.

Alamelu V - Indian J Plast Surg (2011)

Healing by collagen dressing
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111099&req=5

Figure 3: Healing by collagen dressing
Mentions: All the 29 cases (25 males and 4 females) were initially treated with thorough cleaning and dressing. They were analysed as per Clinical findings, aetiology, anatomical site and pathological picture (CEAP classification)[9] for further management by either conservative or surgical modality. Ten cases (34.5%) with shallow, spreading ulcers having only superficial vein thrombosis were treated conservatively with saline or skin substitutes. We used locally available dressings like collagen sheet[10] in three patients [Figure 3], Quinidochlor cream with polyurethane foam dressing in three cases and nanocrystalline silver coated dressing[1112] in four cases. Out of these ten cases, seven cases (24.1% of total 29 cases) healed within 3 months of conservative treatment [Figure 3]. Compression stockings were given concurrently to the affected limb to reduce oedema, lymphostasis, pain and to enhance venous flow. Three cases failed to show healing.

Bottom Line: Remaining nineteen cases were given surgical modality in which fifteen cases (51.74%) were successful.Only seven cases (24.13%) failed to heal.Foot care, regular exercises and follow-up were stressed effectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College and Govt General Hospital, Chennai - 600 003; Sri Jayam Hospital, West Tambaram, Chennai - 600 045; K.J. Hospital and Research Foundation, Poonamallee High Road, Chennai - 600 084, India.

ABSTRACT

Introduction: Venous ulcers of lower limbs are often chronic and non-healing, many a time neglected by patients and their treating physicians as these ulcers mostly do not lead to amputation as in gangrenous arterial ulcer and also cost much to complete the course of treatment and prevention of recurrence.

Materials and methods: One hundred and twenty two lower limb venous ulcers came up for treatment between May 2006 and April 2009. Only twenty nine cases completed the treatment. The main tool of investigation was the non invasive Duplex scan venography. Biopsy of the ulcer was done for staging the disease. Patients' choice of treatment was always conservative and as out-patient instead of hospitalisation and surgery, which required a lot of motivation by the treating unit.

Results: Out of twenty nine cases, ten cases were treated conservatively and seven (24.13%) healed well. Remaining nineteen cases were given surgical modality in which fifteen cases (51.74%) were successful. Only seven cases (24.13%) failed to heal. Compression stockings were advised to control oedema, varices and pain. Foot care, regular exercises and follow-up were stressed effectively.

No MeSH data available.


Related in: MedlinePlus