Cited by 1Diagnosis and Treatment of Venous DiseasesWound Healing and TreatmentsPeripheral Artery Disease Management

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The role of peripheral arterial occlusive disease in the healing of venous ulcers

Open access
Vasilev, Blagoja, Vasileva, Mirela, Vasileva, Stojka·2022·Our Dermatology Online

Abstract

Background: The biggest challenge in patients with chronic venous insufficiency is venous ulcers that occur in stage 6 of the CEAP classification. In general, acute ulcers have a 71–80% chance of healing, while chronic ulcers only have a 22% chance of healing. Our clinical practice has shown that patients diagnosed with peripheral arterial occlusive disease have a much longer duration of the disease and a more difficult treatment of venous ulcers than patients with normal arterial circulation. Materials and Methods: The study included 105 patients with CVI and a developed leg ulcer. Among these, twenty patients were diagnosed with peripheral arterial occlusive disease. All patients were followed for more than twelve weeks. Results: Peripheral arterial occlusive disease was significantly more common in patients with delayed healing than in patients with normal venous ulcer healing: 18 (30%) vs. 2 (4.4%). for twelve weeks or longer, and it was statistically significant for p = 0.00097. Conclusion: Peripheral arterial occlusive disease has been shown to be an important indicator of venous epithelial wound healing. The establishment of good arterial circulation is closely related to the course of treatment of chronic venous ulcers.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In 105 patients with chronic venous insufficiency and leg ulcers, peripheral arterial occlusive disease (PAOD) was strongly associated with delayed venous ulcer healing. PAOD was present in 18 (30%) of patients with delayed healing versus 2 (4.4%) of those with normal healing.

Key findings

  • PAOD was significantly more common in delayed healing than normal healing: 18 (30%) vs. 2 (4.4%), p = 0.00097.
  • Among patients with PAOD, ulcer closure took 4–12 weeks in 2 (7.7%) and ≥12 weeks in 18 (30%); no patient with closure <4 weeks had PAOD.
  • The distribution difference was statistically significant between rapid and delayed healing (p = 0.0066) and between normal and delayed healing (p = 0.025).
  • The authors conclude PAOD is an important indicator/predictive factor for venous ulcer healing and that good arterial circulation is closely related to treatment course.

Methods

  • Study included 105 patients with CVI and a developed leg ulcer; 20 were diagnosed with PAOD. All were followed for more than twelve weeks.
  • Patients were divided by ulcer duration: normal closure up to twelve weeks versus longer than twelve weeks; a secondary table also reports rapid (<4 weeks), normal (4–12 weeks), and delayed (>12 weeks) healing.
  • All received wound dressing and venotonics, with compression therapy given only to patients not diagnosed with PAOD. Analysis used Pearson chi-square tests.

Limitations

  • The paper does not state limitations.
  • Evident from the text: the PAOD subgroup was small (n = 20), and compression therapy was withheld from PAOD patients, so treatment differed between groups.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.7241/ourd.20223.8

Cites

Statistics

Nothing to recompute.

Figures

Figure 1 Frequency of peripheral arterial occlusive disease in patients with normal and delayed ulcer healing.
Figure 1 Frequency of peripheral arterial occlusive disease in patients with normal and delayed ulcer healing.From the PDF
Figure 2 Frequency of peripheral arterial occlusive disease in patients with rapid, normal, and delayed ulcer healing.
Figure 2 Frequency of peripheral arterial occlusive disease in patients with rapid, normal, and delayed ulcer healing.From the PDF

Verification

Claims the paper makes

6 Own result · 3 Own interpretation

  • It may state two separate claims as one. 1
1 of 1
  • The paper relies on this without support.

    Patients diagnosed with peripheral arterial occlusive disease have a much longer duration of the disease and a more difficult treatment of venous ulcers than patients with normal arterial circulation.

    “Our clinical practice has shown that patients diagnosed with peripheral arterial occlusive disease have a much longer duration of the disease and a more difficult treatment of venous ulcers than patients with normal arterial circulation.”
    “Our clinical practice has shown that patients diagnosed with peripheral arterial occlusive disease have a much longer duration of the disease and a more difficult treatment of venous ulcers than patients with normal arterial circulation.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Still being checked.

Research works printed but not linked: 11

  1. [1]1. Recek C. Calf pump activity infl uencing venous hemodynamics in the lower extremity. Int J Angiol. 2013;22:23-30.
  2. [2]2. Franz A, Berndt F, Raabe J, Harmsen JF, Zilkens C, Behringer M. Invasive assessment of hemodynamic, metabolic and ionic consequences during blood fl ow restriction training. Front Physiol. 2020;11:617668.
  3. [3]3. Youn YJ, Lee J. Chronic venous insuffi ciency and varicose veins of the lower extremities. Korean J Intern Med. 2019;34:269-83.
  4. [4]4. Lohr JM, Bush RL. Venous disease in women: Epidemiology, manifestations, and treatment. J Vasc Surg. 2013;57:37S-45S.
  5. [5]5. Kirsten N, Mohr N, Gensel F, Alhumam A, Bruning G, Augustin M. Population-based epidemiologic study in venous diseases in Germany: Prevalence, comorbidity, and medical needs in a cohort of 19,104 workers. Vasc Health Risk Manag. 2021;17:679-87.
  6. [7]7. Raffetto JD. Pathophysiology of wound healing and alterations in venous leg ulcers-review. Phlebology. 2016;31:56-62.
  7. [8]8. Mansilha A, Sousa J. Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. Int J Mol Sci. 2018;19:1669.
  8. [9]9. Szewczyk MT, Mo ś cicka P, Jawie ń A, Cwajda-Bia ł asik J, Cierzniakowska K, Ś lusarz R, et al. Quality of life in patients with leg ulcers or skin lesions: A pilot study. Postepy Dermatol Alergol. 2015;32:465-9.
  9. [10]10. Vishwanath V. Quality of life: Venous leg ulcers. Indian Dermatol Online J. 2014;5:397-9.
  10. [12]12. Raffetto JD, Ligi D, Maniscalco R, Khalil RA, Mannello F. Why venous leg ulcers have difficulty healing: Overview on pathophysiology, clinical consequences, and treatment. J Clin Med. 2020;10:29.
  11. [13]13. Manna B, Nahirniak P, Morrison CA. Wound Debridement. 2021 Sep 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 29939659.

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Metadata

Authors
Vasilev, B., Vasileva, M., & Vasileva, S.
Venue
Our Dermatology Online
Published
2022-07-01
Volume
13
Issue
3
Pages
280-282
ISSN
2081-9390 (ISSN-L)
OpenAlex
W4283643434
Cited by
1
References
0
Citations by year
2023: 1
FWCI
0.21
Type
journal article
Language
en
Open access
Locations
Our Dermatology Online (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Diagnosis and Treatment of Venous Diseases
  • Health Sciences › Medicine › Surgery › Wound Healing and Treatments
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Keywords
peripheral arterial disease, venous ulcers, chronic venous insufficiency, wound healing, leg ulcers, CEAP classification, arterial circulation, delayed healing

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