A Review of the Microcirculation in Skin in Patients With Chronic Venous Insufficiency: The Problem and the Evidence Available for Therapeutic Options
Identifieur interne : 001967 ( Istex/Curation ); précédent : 001966; suivant : 001968A Review of the Microcirculation in Skin in Patients With Chronic Venous Insufficiency: The Problem and the Evidence Available for Therapeutic Options
Auteurs : Uwe Wollina [Allemagne] ; Mohamed Badawy Abdel-Naser [Égypte] ; Raj Mani [Royaume-Uni]Source :
- The International Journal of Lower Extremity Wounds [ 1534-7346 ] ; 2006-09.
Abstract
Impairment of the cutaneous microcirculation is a major predisposing factor in inflammation and ulceration in patients with chronic venous insufficiency (CVI). Increase of capillary filtration rate predisposes to the formation of edema. Local lymphedema is a complication of CVI, often underdiagnosed. This review is focused on CVI but excludes the complication of ulceration. Treatment of microcirculatory dysfunction can be done by pharmacologic intervention or compression therapy or using a combination of both. This review is focused on drugs that have been evaluated by randomized prospective controlled trials. The following compounds are discussed: horse chestnut seed extracts, flavonoids, red vine leaves extracts, total triterpenic fraction of Centella asiatica (L), prociadins, calcium dobesilate, and pentoxifylline. The microcirculatory effects of compression therapy using bandages or stockings are also reviewed. The major microcirculatory effects that have been shown are the reduction of capillary filtration rate and improvements in levels of transcutaneous partial pressures of oxygen and carbon dioxide (TcPO2 and TcPCO2). Available data suggest that a combination of pharmacologic and compression therapy may have some additive effects.
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DOI: 10.1177/1534734606291870
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Uwe Wollina<affiliation><mods:affiliation></mods:affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation wicri:level="1"><mods:affiliation>E-mail: wollina-uw@khdf.de</mods:affiliation><country wicri:rule="url">Allemagne</country></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Dermatology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Germany, wollina-uw@khdf.de</mods:affiliation><country wicri:rule="url">Allemagne</country><wicri:regionArea>Department of Dermatology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Germany</wicri:regionArea></affiliation>Le document en format XML
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wicri:rule="url">Allemagne</country></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Dermatology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Germany, wollina-uw@khdf.de</mods:affiliation><country wicri:rule="url">Allemagne</country><wicri:regionArea>Department of Dermatology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Germany</wicri:regionArea></affiliation></author><author><name sortKey="Abdel Naser, Mohamed Badawy" sort="Abdel Naser, Mohamed Badawy" uniqKey="Abdel Naser M" first="Mohamed Badawy" last="Abdel-Naser">Mohamed Badawy Abdel-Naser</name><affiliation wicri:level="1"><mods:affiliation>Department of Dermatology and Venereology, Ain Shams University Hospital, Cairo, Egypt</mods:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Dermatology and Venereology, Ain Shams University Hospital, 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Increase of capillary filtration rate predisposes to the formation of edema. Local lymphedema is a complication of CVI, often underdiagnosed. This review is focused on CVI but excludes the complication of ulceration. Treatment of microcirculatory dysfunction can be done by pharmacologic intervention or compression therapy or using a combination of both. This review is focused on drugs that have been evaluated by randomized prospective controlled trials. The following compounds are discussed: horse chestnut seed extracts, flavonoids, red vine leaves extracts, total triterpenic fraction of Centella asiatica (L), prociadins, calcium dobesilate, and pentoxifylline. The microcirculatory effects of compression therapy using bandages or stockings are also reviewed. The major microcirculatory effects that have been shown are the reduction of capillary filtration rate and improvements in levels of transcutaneous partial pressures of oxygen and carbon dioxide (TcPO2 and TcPCO2). 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