title: Treatment options for venous leg ulcers: effectiveness of vascular surgery, bioengineered tissue, and electrical stimulation.
abstract: OBJECTIVE
  To evaluate the peer-reviewed literature that compares advanced venous leg ulcer therapies to standard of care with compression dressings.
  
  
  METHODS
  A MEDLINE search for venous ulcer treatment with electrical stimulation, surgical vein correction, and bioengineered tissues was conducted. Randomized clinical trials comparing advanced treatment with standard of care using compression dressing were included. A total of 7 bioengineered tissue, 4 surgical treatment, and 4 electrical stimulation randomized clinical trials were identified.
  
  
  RESULTS
  Compared with nonstandard treatments, electrical stimulation demonstrated improved wound healing, fewer adverse events, and shorter duration of healing. Healing rates at the end of the study were greater for surgical intervention, followed by similar outcomes for electrical stimulation and bioengineered tissues. Studies involving bioengineered tissues and surgical venous ablation demonstrated inconsistent/inconclusive results.
  
  
  CONCLUSIONS
  Utilization of electrical stimulation in venous ulcer management has not been fully explored. Further studies of dosing electrical stimulation therapy may reveal therapeutic and preventive benefits for managing venous ulcers not yet elucidated.
authors.affiliation: Gaurav Thakral, MD, is Research Staff, and Javier La Fontaine, DPM, MS, is Associate Professor; both at the Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas. Paul Kim, DPM, is Associate Professor, Department of Plastic Surgery, Georgetown University School of Medicine, Washington, District of Columbia. Bijan Najafi, PhD, is Associate Professor of Surgery and Engineering, Department of Surgery, University of Arizona School of Medicine, Phoenix, Arizona. Adam Nichols, DPM, is a Fellow, and Lawrence A. Lavery, DPM, MPH, is Professor, Department of Plastic Surgery, and is Codirector of Research and Medical Director of the Comprehensive Wound Care Center; The University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Thakral
authors.forename: Javier
authors.initials: J
authors.lastname: La Fontaine
authors.forename: Paul
authors.initials: P
authors.lastname: Kim
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
authors.forename: Adam
authors.initials: A
authors.lastname: Nichols
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Lavery
mesh_terms: D001458:Bandages; D001807:Blood Vessel Prosthesis; D004599:Electric Stimulation Therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017768:Skin, Artificial; D023822:Tissue Engineering; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000628:therapy*; D014656:Vascular Surgical Procedures