Venous Ulcers
Identifieur interne : 004836 ( Pmc/Corpus ); précédent : 004835; suivant : 004837Venous Ulcers
Auteurs : J. A. Caprini ; H. Partsch ; R. SimmanSource :
- The Journal of the American College of Clinical Wound Specialists [ 2213-5103 ] ; 2013.
Abstract
Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence.
Url:
DOI: 10.1016/j.jccw.2013.11.001
PubMed: 26236636
PubMed Central: 4511547
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PMC:4511547Le document en format XML
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<author><name sortKey="Caprini, J A" sort="Caprini, J A" uniqKey="Caprini J" first="J. A." last="Caprini">J. A. Caprini</name>
<affiliation><nlm:aff id="aff1">Department of Surgery, Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, IL, USA</nlm:aff>
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<affiliation><nlm:aff id="aff2">Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA</nlm:aff>
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<author><name sortKey="Partsch, H" sort="Partsch, H" uniqKey="Partsch H" first="H." last="Partsch">H. Partsch</name>
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<author><name sortKey="Simman, R" sort="Simman, R" uniqKey="Simman R" first="R." last="Simman">R. Simman</name>
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<affiliation><nlm:aff id="aff5">Department of Pharmacology and Toxicology, Wright State University Boonshoft School of Medicine, Dayton 45435, OH, USA</nlm:aff>
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<author><name sortKey="Partsch, H" sort="Partsch, H" uniqKey="Partsch H" first="H." last="Partsch">H. Partsch</name>
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<author><name sortKey="Simman, R" sort="Simman, R" uniqKey="Simman R" first="R." last="Simman">R. Simman</name>
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<front><div type="abstract" xml:lang="en"><p>Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence.</p>
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<pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Am Coll Clin Wound Spec</journal-id>
<journal-id journal-id-type="iso-abbrev">J Am Coll Clin Wound Spec</journal-id>
<journal-title-group><journal-title>The Journal of the American College of Clinical Wound Specialists</journal-title>
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<issn pub-type="epub">2213-5103</issn>
<publisher><publisher-name>Elsevier</publisher-name>
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<article-id pub-id-type="publisher-id">S2213-5103(13)00072-9</article-id>
<article-id pub-id-type="doi">10.1016/j.jccw.2013.11.001</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
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<title-group><article-title>Venous Ulcers</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Caprini</surname>
<given-names>J.A.</given-names>
</name>
<degrees>MD, MS, FACS, RVT</degrees>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff2" ref-type="aff">b</xref>
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<contrib contrib-type="author"><name><surname>Partsch</surname>
<given-names>H.</given-names>
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<degrees>MD</degrees>
<xref rid="aff3" ref-type="aff">c</xref>
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<contrib contrib-type="author"><name><surname>Simman</surname>
<given-names>R.</given-names>
</name>
<degrees>MD, FACS, FACCWS</degrees>
<email>plasticsimman@yahoo.com</email>
<xref rid="aff4" ref-type="aff">d</xref>
<xref rid="aff5" ref-type="aff">e</xref>
<xref rid="cor1" ref-type="corresp">∗</xref>
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<aff id="aff1"><label>a</label>
Department of Surgery, Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, IL, USA</aff>
<aff id="aff2"><label>b</label>
Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA</aff>
<aff id="aff3"><label>c</label>
Department of Dermatology, Medical University of Vienna, Austria</aff>
<aff id="aff4"><label>d</label>
Division of Plastic and Reconstructive Surgery, Wright State University Boonshoft School of Medicine, Dayton 45435, OH, USA</aff>
<aff id="aff5"><label>e</label>
Department of Pharmacology and Toxicology, Wright State University Boonshoft School of Medicine, Dayton 45435, OH, USA</aff>
<author-notes><corresp id="cor1"><label>∗</label>
Corresponding author. Wright state University, Department of Pharmacology and Toxicology, Dayton 45435, USA. <email>plasticsimman@yahoo.com</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release"><day>04</day>
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<volume>4</volume>
<issue>3</issue>
<fpage>54</fpage>
<lpage>60</lpage>
<history><date date-type="received"><day>14</day>
<month>10</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><day>14</day>
<month>11</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>14</day>
<month>11</month>
<year>2013</year>
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<permissions><copyright-statement>© 2014 Elsevier Inc. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
<copyright-holder>Elsevier Inc.</copyright-holder>
</permissions>
<abstract><p>Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Venous ulcer</kwd>
<kwd>Venous insufficiency</kwd>
<kwd>Compression therapy</kwd>
<kwd>Wound care</kwd>
</kwd-group>
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