title: 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.
abstract: 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.
authors.affiliation: Irvine Vascular Laboratory and Physiology, Department of Biomedical Sciences, Chieti University, San Valentino Vascular Screening Project, PE, Italy. cardres@abol.it
authors.forename: Gianni
authors.initials: G
authors.lastname: Belcaro
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Cesarone
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Errichi
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Renzo
authors.forename: Silvia
authors.initials: S
authors.lastname: Errichi
authors.forename: Andrea
authors.initials: A
authors.lastname: Ricci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gizzi
authors.forename: Mark
authors.initials: M
authors.lastname: Dugall
authors.forename: Marisa
authors.initials: M
authors.lastname: Cacchio
authors.forename: Irma
authors.initials: I
authors.lastname: Ruffini
authors.forename: Filiberto
authors.initials: F
authors.lastname: Fano
authors.forename: Giulia
authors.initials: G
authors.lastname: Vinciguerra
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Grossi
mesh_terms: 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
chemical_list: D002317:Cardiovascular Agents; C475179:Crystacide; D005609:Free Radicals; D009824:Ointments; D006861:Hydrogen Peroxide