Improvement of microcirculation and healing of venous hypertension and ulcers with Crystacide: evaluation with a microcirculatory model, including free radicals, laser doppler flux, and PO2/PCO2 measurements.
In 32 patients with chronic venous insufficiency and venous hypertension associated with ulcerations, the effects of the local application of a hydrogen peroxide cream (Crystacide) applied onto the skin was evaluated using a complex, proportional, microcirculatory model to assess and quantify venous microangiopathy after local treatment. A comparative group treated without Crystacide was included. Laser Doppler flowmetry was used to assess skin perfusion (flux and venoarteriolar response) in association with transcutaneous PO2 and PCO2 measurements. Local plasma free radicals were evaluated in the area surrounding the venous ulcer using the D-Roms test. Crystacide was applied around and on the ulcer for 10 days. Crystacide was more effective than the control treatments. PO2 was increased (improved, P < .05), and plasma free radicals, PCO2, and laser Doppler flowmetry were decreased (improving toward normal values, P < .05). Also, the ulcerated area was significantly smaller at 10 days in the Crystacide group in comparison with controls (P < .05). In the proportional microcirculatory model, all parameters indicated an important level of improvement significantly larger than in controls. In conclusion, in chronic venous insufficiency and venous ulcerations, local treatment with Crystacide (10 days) improves the microcirculation and decreases skin free radicals, thus improving healing.
Belcaro
Gianni
G
Irvine Vascular Laboratory and Physiology, Department of Biomedical Sciences, Chieti University, San Valentino Vascular Screening Project, PE, Italy. cardres@abol.it
Cesarone
Maria Rosaria
MR
Errichi
Bruno M
BM
Di Renzo
Andrea
A
Errichi
Silvia
S
Ricci
Andrea
A
Gizzi
Giuseppe
G
Dugall
Mark
M
Cacchio
Marisa
M
Ruffini
Irma
I
Fano
Filiberto
F
Vinciguerra
Giulia
G
Grossi
Maria Giovanna
MG
D000279:Administration, Cutaneous; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D001785:Blood Gas Monitoring, Transcutaneous; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005609:Free Radicals / Q000097:blood*; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage / Q000627:therapeutic use*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D008955:Models, Cardiovascular; D015233:Models, Statistical; D009824:Ointments; D012867:Skin / Q000098:blood supply; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014689:Venous Insufficiency / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D014690:Venous Pressure / Q000187:drug effects*; D014945:Wound Healing / Q000187:drug effects
D002317:Cardiovascular Agents; C475179:Crystacide; D005609:Free Radicals; D009824:Ointments; D006861:Hydrogen Peroxide