ABSTRACT
Abstract Chronic ulcers significantly affect the quality of life of patients and impose a high cost on the healthcare system. The therapeutic management should be comprehensive, taking into consideration the etiological diagnosis of the wound and the characteristics of the wound bed when deciding on a therapeutic proposal appropriate to the healing phase, correcting factors that delay healing. During the epithelialization phase, repair techniques with grafts are recommended to shorten re-epithelialization time, improve the quality of scar tissue, and achieve adequate pain management. Currently, due to the reported benefits of skin appendages, the technique of follicular unit auto-grafting obtained with a scalp punch is among the chosen strategies for wound repair. This is a minimally invasive, outpatient practice, whose technique has advantages over the donor site, patients recovery and well-being.
ABSTRACT
Objective:To investigate the mechanism of inhibiting inflammatory response by negative pressure wound therapy in the chronic venous leg ulcer.Method:The clinical data of 29 patients with chronic VLU treated in Hechuan-Rhine Traditional Chinese Medicine Hospital of Shanghai from June 2018 to December 2021 were collected.According to different treatment meth-ods,the patients were divided into the control group(n=13)and the observation group(n=16).The control group adopted routine varicose vein operations and debridement,routine dressing change was performed on the VLU wound every other day after operation.The observation group adopted debridement and then NPWT on the basis of routine varicose vein operations,the VLU wound was continuously drained with negative pressure for 1 week after operation.IL-1β and IL-18 levels were measured with ELISA.ASC、NLRP3 and Caspase-1 levels were detected with Western blot-ting.The autologous skin transplantation time of the two groups were calculated by survival curve analysis.Results:The inflammatory response was milder in the observation group than in the con-trol group 7 days after operation.The results of ELISA showed that the levels of IL-1 p and IL-18 in the observation group were lower than those in the control group.The results of Western blotting showed that the relative expression levels of ASC、NLRP3 and Caspase-1 in the observation group were lower than those in the control group.The survival curve analysis showed that the autologous skin transplantation time of the observation group was less than the control group.Conclusion:The inflammatory response can be distinctly alleviated by NPWT in the VLU,leading to better condi-tions for autologous skin transplantation within a short period.
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Objective To translate the Venous Leg Ulcer Quality of life Questionnaire (VLU-QoL) into Chinese and evaluate the reliability and validity of Chinese version.Methods VLU-QoL was translated into Chinese according to the standards setted by ISPOR.Totally 232 patients with venous leg ulcer were recruited and investigated by the Chinese version of VLU-QoL.Results The Chinese version of VLU-QoL comprised 34 items,Cronbach α was 0.940,inter-rater reliability was 0.841;test-retest reliability was 0.825.I-CVI was 0.83-1.00,S-CVI/Ave was 0.955;Criterion-related validity were 0.714 and 0.541;factor analysis got 3 factors,which explained 54.367％ of the total variance.Conclusions The Chinese version of VLU-QoL has been proved to be reliable and valid.It can be used as a valid tool for the measurement of quality of life for patients with venous leg ulcer.
ABSTRACT
Venous leg ulcers, the most common form of leg ulcers, are relevant to the pathogenicity of pericapillary fibrin cuff. Sarcoidosis, a multiorgan granulomatous disease, causes fibrin deposition in tissues. We report a case of a 50-year-old man with venous leg ulcers coexisting with sarcoidosis. On the basis of the histologic findings, we propose the hypothesis that sarcoidosis patients are prone to the development of venous leg ulcers.
Subject(s)
Humans , Middle Aged , Capillaries , Fibrin , Leg Ulcer , Leg , Sarcoidosis , VirulenceABSTRACT
Objective To study the surgical treatment of venous leg ulcer. Methods The surgical treatment of venous leg ulcer in 101 cases from January 1980 to December 2002 in our hospital was retrospectively analyzed. Results Of 72 cases undergoing subfascial communicating vein ligation around the base of the ulcer, 52 cases were healed within 1 to 3 months, 12 cases within 4 to 5 months, 8 cases after skin graft, but 3 cases were complicated with postoperative infection and 2 cases suffered from relapse of ulcer. However, of the 12 cases undergoing peripheral transfixion of the ulcer through the skin, 2 cases were complicated with skin necrosis and infection, 10 cases healed within 6 months to 1 year. All the 11 cases undergoing endoscopic communicating vein dissection were healed without complications within 1～2 months. Conclusion The surgical procedures for venous leg ulcer should be performed to block the regurgitation of the communicating veins by means of lowering the venous leg pressure. Endoscopic communicating vein ligation or spiral dissection of the communicating vein is valuable in clinical application.