Possibilities of conservative treatment of patients with chronic venous insufficiency of the lower extremities С6–С6r and previously eliminated superficial veins
Abstract
Venous ulcers are widespread. Affecting about 1% of the adult population they represent a significant social and economic burden. A special category of patients who have non-healing or recurrent ulcers after previously open or endovascular surgery on superficial varicose veins. We observed 13 such patients without diabetes mellitus – 5 men and 8 women. The average age was 58.7±5.3 years. In accordance with Russian and international clinical guidelines, compression of the affected limbs with three-layer bandages was performed. Also, adjuvant phlebotropic therapy was prescribed. After sanitation and gentle debridement, superabsorbent dressings Zetuvit Plus Silicone with a contact layer of silicone were used. Patients were treated on an outpatient basis, the dressing was changed every 3–5 days, then these periods were extended. Improvement was noted after 7–8 days. By the end of the second month, the wound had healed in 11 of 13 patients, and significantly decreased in size in one patient. Based on the presented experience, Zetuvit Plus Silicone dressings is the modern concept of moist management of chronic wounds with abundant exudation. They provide active absorption of discharge and unpleasant odor, create an optimal microclimate and conditions for healing, protect vulnerable skin around the wound, maintain temperature stability and allow for good results of conservative treatment with psychosocial comfort for patients (in particular, with previously eliminated superficial veins).
About the Authors
A. A. Fokin
South-Urals State Medical University; Samarkand State Medical University
Russian Federation
Russian Federation
Chelyabinsk
Samarkand, Republic of Uzbekistan
D. A. Borsuk
South-Urals State Medical University; Kazakhstan-Russian Medical University; SMT-Clinic, LLC «Modern Medical Technologies»
Russian Federation
Russian Federation
Chelyabinsk
Almaty, Kazakhstan
A. V. Sazanov
Regional Clinical Hospital No. 3
Russian Federation
Russian Federation
Chelyabinsk
K. O. Zhdanov
SMT-Clinic, LLC «Modern Medical Technologies»
Russian Federation
Russian Federation
Chelyabinsk
References
1. Körber A., Jockenhöfer F., Sondermann W. et al. First manifestation of leg ulcers: Analysis of data from 1000 patients //Der Hautarzt. – 2017. – Т. 68. – С. 483-491.
2. Körber A., Klode J., Al-Benna S. et al. Etiology of chronic leg ulcers in 31,619 patients in Germany analyzed by an expert survey // JDDG: Journal der Deutschen Dermatologischen Gesellschaft. – 2011. – Т. 9. – №. 2. – С. 116-121.
3. Guest J. F., Fuller G. W., Vowden P. Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013 // BMJ open. – 2020. – Т. 10. – №. 12. – С. e045253.
4. Rajhathy E. M., Murray H. D., Roberge V. A., Woo K. Y. Healing rates of venous leg ulcers managed with compression therapy: a secondary analysis of data // Journal of Wound Ostomy & Continence Nursing. – 2020. – Т. 47. – №. 5. – С. 477-483.
5. Abbade L. P. F., Lastória S. Venous ulcer: epidemiology, physiopathology, diagnosis and treatment // International journal of dermatology. – 2005. – Т. 44. – №. 6. – С. 449-456.
6. Berenguer Pérez M., López-Casanova P., Sarabia Lavín R. et al. Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre—A time series study (2010-2014) // International Wound Journal. – 2019. – Т. 16. – №. 1. – С. 256-265.
7. Raffetto J. D., Ligi D., Maniscalco R. et al. Why venous leg ulcers have difficulty healing: overview on pathophysiology, clinical consequences, and treatment // Journal of clinical medicine. – 2020. – Т. 10. – №. 1. – С. 29.
8. Weller C. D., Richards C., Turnour L., Team V. Patient explanation of adherence and non-adherence to venous leg ulcer treatment: a qualitative study // Frontiers in pharmacology. – 2021. – Т. 12. – С. 663570.
9. Probst S., Séchaud L., Bobbink P. et al. The lived experience of recurrence prevention in patients with venous leg ulcers: an interpretative phenomenological study // Journal of tissue viability. – 2020. – Т. 29. – №. 3. – С. 176-179.
10. González-Consuegra R. V., Verdú J. Quality of life in people with venous leg ulcers: an integrative review // Journal of advanced nursing. – 2011. – Т. 67. – №. 5. – С. 926-944.
11. O'Donnell T. F. Jr, Passman M. A., Marston W. A. et al. Management of venous leg ulcers: clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum // Journal of vascular surgery. – 2014. – Т. 60. – №. 2. – С. 3S-59S.
12. Mosti G., De Maeseneer M., Cavezzi A. et al. Society for Vascular Surgery and American Venous Forum Guidelines on the management of venous leg ulcers: the point of view of the International Union of Phlebology // International angiology: a journal of the International Union of Angiology. – 2015. – Т. 34. – №. 3. – С. 202-218.
13. De Maeseneer M. G., Kakkos S. K., Aherne T. et al. Editor's choice–European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs // European Journal of Vascular and Endovascular Surgery. – 2022. – Т. 63. – №. 2. – С. 184-267.
14. Gloviczki P., Lawrence P. F., Wasan S.M. et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine // Journal of Vascular Surgery: Venous and Lymphatic Disorders. – 2024. – Т. 12. – №. 1. – С. 101670.
15. Langan E. A., Wienandt M., Bayer A. et al. Effect of obesity on venous blood flow in the lower limbs //JDDG: Journal der Deutschen Dermatologischen Gesellschaft. – 2023. – Т. 21. – №. 6. – С. 622-629.
16. Mazzolai L., Teixido-Tura G., Lanzi S. et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases: Developed by the task force on the management of peripheral arterial and aortic diseases of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS), the European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN), and the European Society of Vascular Medicine (ESVM) // European heart journal. – 2024. – Т. 45. – №. 36. – С. 3538-3700.
17. Lee B. B., Nicolaides A. N., Myers K. et al. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence // Int Angiol. – 2016. – Т. 35. – №. 3. – С. 236-352.
18. Vedantham S., Weinberg I., Desai K. R. et al. Society of interventional radiology position statement on the management of chronic iliofemoral venous obstruction with endovascular placement of metallic stents // Journal of Vascular and Interventional Radiology. – 2023. – Т. 34. – №. 10. – С. 1643-1657. e6.
19. Ulloa J. H., Glickman M. One-year first-in-human success for venovalve in treating patients with severe deep venous insufficiency // Vascular and Endovascular Surgery. – 2022. – Т. 56. – №. 3. – С. 277-283.
20. Marston W., Muluk S., Sadek M. et al. Initial US experience with the BlueLeaf Endovenous Valve Formation System // Journal of Vascular Surgery: Venous and Lymphatic Disorders. – 2022. – Т. 10. – №. 2. – С. 566.
21. Barrett S., Rippon M., Rogers A. A. Treatment of 52 patients with a self-adhesive siliconised superabsorbent dressing: a multicentre observational study // Journal of Wound Care. – 2020. – Т. 29. – №. 6. – С. 340-349.
22. Atkin L., Barrett S., Chadwick P. et al. Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series // Journal of wound care. – 2020. – Т. 27. – №. 2. – С. 174-182.
23. Urwin S., Dumville J. C., Sutton M., Cullum N. Health service costs of treating venous leg ulcers in the UK: evidence from a cross-sectional survey based in the north west of England // BMJ open. – 2022. – Т. 12. – №. 1. – С. e056790.
24. Nussbaum S. R., Carter M. J., Fife C. E. et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds // Value in health. – 2018. – Т. 21. – №. 1. – С. 27-32.
25. Weller C., Evans S. Venous leg ulcer management in general practice: Practice nurses and evidence based guidelines // Australian family physician. – 2012. – Т. 41. – №. 5.
26. Probst S., Saini C., Gschwind G. et al. Prevalence and incidence of venous leg ulcers—a systematic review and meta-analysis // International wound journal. – 2023. – Т. 20. – №. 9. – С. 3906-3921.
Review
For citations:
Fokin A.A., Borsuk D.A., Sazanov A.V., Zhdanov K.O. Possibilities of conservative treatment of patients with chronic venous insufficiency of the lower extremities С6–С6r and previously eliminated superficial veins. Title in english. 2024;19(4):3-6. (In Russ.)
Views:
77
Email this article 