[Ambulatory treatment of postphlebitic ulcers of lower limbs. Physiopathological bases and clinical results].
Venous ulceration is a troublesome and disabling complication, representing one of the most difficult problems to be treated by the vascular surgeon. Venous insufficiency is a widespread condition, the prevalence of venous ulceration being 0.5 - 1 per cent in European populations. Although all venous ulcers will heal if the limb is elevated above heart level for an extended period of time, patients need a safe, effective, not disabling and quick therapy. Hence, the competent vascular surgeon must be familiar with venous pathophysiology and possess a thorough understanding of the treatment options available for a discouraged patient in need of an acceptable and effective approach. The aim of the present study was to assess the efficacy and the speed of healing of venous ulcer using an outpatient ambulatory treatment protocol. This protocol consisted of elastic compression bandage allowing deambulation, local dressing using lyophilized heterologous collagen (Condress, Gentili) and systemic profibrinolytic drugs. Exclusion criteria were coexisting arterial insufficiency, ulcer area greater than 25 cm2, coexisting disabling diseases (congestive cardiac failure, hepatic insufficiency, malignancy). From December 1990 to June 1993, 37 patients affected by venous ulcer were treated, according to the aforementioned protocol, at the Surgical Department of Montecchio Maggiore Hospital (VI). There were 16 male and 21 female patients, mean age was 66 years (range 59-91). Results show the complete healing of the venous ulcer in 94.5% of patients; mean time for ulcer healing was 128 days (range 45-91). The Authors conclude that the outpatient ambulatory treatment protocol is safe, quick, and effective for the therapy of chronic venous ulcer; once obtained the healing of the ulcer, elastic compressive bandage with elastic stockings is mandatory to prevent recurrences.
Perri
S
S
Divisione di Chirurgia Generale, Stabilimento Ospedaliero di Montecchio Maggiore, VI.
Amendolara
M
M
Gallo
G
G
Breda
E
E
Valenti
G
G
Meneghini
G
G
Pietrangeli
F
F
Gelmi
G F
GF
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001458:Bandages; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011186:Postphlebitic Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors
D005343:Fibrinolytic Agents
Il trattamento ambulatoriale delle ulcere postflebitiche degli arti inferiori. Basi fisiopatologiche e risultati clinici.