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Conde-Montero E, Dissemond J, Protz K. Compression Therapy in Dermatology. Actas Dermosifiliogr 2024:S0001-7310(24)00156-X. [PMID: 38382747 DOI: 10.1016/j.ad.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
The benefit of lower limb compression therapy is not limited to chronic venous insufficiency or/and lymphoedema. Thanks to its anti-edema and anti-inflammatory effects, compression therapy is considered a beneficial adjuvant therapy to treat atypical wounds, inflammatory dermatoses, cellulitis, and traumatic wounds in the absence of contraindications. Strict contraindications are limited to severe peripheral arterial disease and decompensated heart failure. The variability of commercially available compression materials and systems, such as short-stretch bandages, multi-component systems, zinc oxide bandages, medical adaptive compression systems, ulcer compression stockings or medical compression stockings, facilitates the adaptation of compression therapy to the individual needs of each patient. Compared to venous leg ulcers, low pressures of 20mmHg are often sufficient to treat dermatological disorders, with higher patient tolerance and compliance.
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Affiliation(s)
- E Conde-Montero
- Servicio de Dermatología. Hospital Universitario Infanta Leonor y Virgen de la Torre, Madrid.
| | - J Dissemond
- Department of Dermatology, Venerology and Allergology, University Hospital Essen, Essen, Germany
| | - K Protz
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Asséré YAGRA, Kaba L, Assi-Dje Bi Dje V, Akpro LR. [Elephantiasis of the lower limb: Treatment of seven cases using the modified Charles technique]. ANN CHIR PLAST ESTH 2023; 68:354-360. [PMID: 35927107 DOI: 10.1016/j.anplas.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Lymphedema is an obstructive dysfunction of the lymphatic system characterised by an inability of the lymphatic system to eliminate excess lymphatic load. It can be congenital or secondary. Untreated, it progresses in three stages, the final stage being elephantiasis. We report a short series of 7 cases of elephantiasis of the lower limb treated with the Charles technique. Our aim was to describe the results of the surgical treatment. METHOD This was a retrospective descriptive and analytical study from January 2010 to December 2020. Patients with at least one lower limb elephantiasis of any aetiology of any age and gender who underwent excisional surgery with a complete medical record containing clinical and therapeutic data were included. RESULTS During the study period, we received 710 patients with a prevalence of elephantiasis of 1.69%. The mean age was 43.3±14.5years with a male predominance. No etiology or co-morbidity factors (diabetes, hypertension, VRS) were found. In our mini-series, the average time between the two procedures was 34.3±9.6days. The mean time to healing was 82.3±15.1days. All patients healed with two excellent results. CONCLUSION excisional surgery with two-stage repair combined with compression therapy gave satisfactory results.
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Affiliation(s)
- Y A G R A Asséré
- Service de chirurgie réparatrice, plastique et de la main de l'Institut Raoul Follereau Adzopé, Cote d'Ivoire.
| | - L Kaba
- Service de chirurgie réparatrice, plastique et de la main de l'Institut Raoul Follereau Adzopé, Cote d'Ivoire.
| | - V Assi-Dje Bi Dje
- Service de chirurgie plastique, de la main et brulologie du CHU de Treichville, Abidjan.
| | - L R Akpro
- Service de traumatologie-orthopédie et chirurgie réparatrice du CHU de Bouaké.
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Guest JF, Fuller GW. Relative cost-effectiveness of three compression bandages in treating newly diagnosed venous leg ulcers in the UK. J Wound Care 2023; 32:146-158. [PMID: 36930185 DOI: 10.12968/jowc.2023.32.3.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To assess the clinical outcomes and cost-effectiveness of using a two-layer cohesive compression bandage (TLCCB; Coban 2, 3M, US) compared with a two-layer compression system (TLCS; KTwo, Urgo, France) and a cohesive inelastic bandage system (CIBR; Actico, L&R, Germany) in treating newly diagnosed venous leg ulcers (VLUs) in clinical practice, from the perspective of the UK's National Health Service (NHS). METHOD This was a modelling study based on a retrospective cohort analysis of the case records of patients with a newly diagnosed VLU randomly extracted from the The Health Improvement Network (THIN) database who were treated with TLCCB, TLCS or CIBR. No significant differences were detected between the groups. Nevertheless, analysis of covariance was performed to enable differences in patients' outcomes between the groups to be adjusted for any heterogeneity in baseline covariates. Clinical outcomes and cost-effectiveness of the alternative compression systems were estimated over 12 months after starting treatment. RESULTS There were 250 patients in each group. Time from wound onset to starting compression was a mean of two months. The healing distribution of the TLCCB-treated patients was significantly different from that of the other two cohorts (p=0.003); the probability of healing at 12 months was 0.62, 0.51 and 0.49 in the TLCCB, TLCS and CIBR groups, respectively. Patients treated with TLCCB experienced better health-related quality of life (HRQoL) over 12 months (0.86 quality-adjusted life years (QALYs) per patient), compared with those treated with TLCS and CIBR (0.83 and 0.82 QALYs per patient, respectively). The 12-month NHS wound management cost was £3693, £4451 and £4399 per patient in the TLCCB, TLCS and CIBR groups, respectively. CONCLUSION Within the model's limitations, treating newly diagnosed VLUs with TLCCB instead of the other two compression systems appears to afford a more cost-effective use of NHS-funded resources in clinical practice, since it is expected to result in increased healing, better HRQoL and a lower wound management cost for the NHS.
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Yoshihara M, Kitamura K, Tsuru S, Shimono R, Sakuda H, Mayama M, Tano S, Uno K, Ukai MO, Kishigami Y, Oguchi H, Hirota A. Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study. BMC Cancer 2022; 22:25. [PMID: 34980013 PMCID: PMC8722292 DOI: 10.1186/s12885-021-09163-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment. Methods We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined. Results In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT. Conclusions Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.
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Affiliation(s)
- Masato Yoshihara
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Kaoru Kitamura
- Department of Breast Surgery, Kaizuka Hospital, 7-7-27 Hakozaki, Higashi-ku, Fukuoka, Fukuoka, 812-0053, Japan
| | - Satoko Tsuru
- School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
| | - Ryoko Shimono
- Organization for Interdisciplinary Research Project, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Hiromi Sakuda
- Graduate School of Nursing, Osaka City University, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka-shi, 558-8585, Japan
| | - Michinori Mayama
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan.,Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita 8, Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-0808, Japan
| | - Sho Tano
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Kaname Uno
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Mayu Ohno Ukai
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Yasuyuki Kishigami
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Hidenori Oguchi
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Akio Hirota
- Hirota Internal Medicine Clinic, 5-19-10 Minami-karasuyama, Setagaya-ku, Tokyo, 157-0062, Japan
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Leinung M, Loth AG, Kroth M, Burck I, Stöver T, Helbig S. Comparison of bandaging techniques to prevent cochlear implant magnet displacement following MRI. Eur Arch Otorhinolaryngol 2021; 278:4209-4216. [PMID: 33386972 DOI: 10.1007/s00405-020-06504-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION For cochlear implants (CI) with removable magnets, a pressure bandage usually is recommended during MR imaging to avoid magnet dislocation. Nevertheless, this complication is regularly observed despite applying a pressure bandage. The aim of this study was to compare various bandaging techniques to avoid magnet displacement. MATERIALS AND METHODS As an experimental model a force measuring stand was developed and validated, on which the process of magnet dislocation could be simulated on a cochlear implant. In a test series with six combinations of cohesive and elastic bandages with different counter pressure elements (CPE), the forces required to induce magnet dislocation against the resistance of a compression bandage was determined. In addition, the inter- and intraindividual variability of the compression bandages was measured for ten different users. RESULTS The cohesive bandage had the lowest average holding force of 10.70 N. The elastic bandage developed more than four times the retention force of the cohesive bandage (44.88 N, p < 0.01). By adding a CPE, these values could be increased highly significantly up to factor 3. The optimum combination in terms of fixation force against magnet dislocation was an elastic bandage plus a cylindrical CPE (76.60 N). The data showed a high interindividual variability. CONCLUSION Even though most CI manufacturers now offer 3T-conditional implants, a pressure bandage will have to be applied to thousands of patients with previous implant generations to prevent magnet dislocation. We examined for the first time force measurements to compare different bandaging techniques by detecting the holding force of the CI magnet. We were able to identify an optimized combination of a bandage and a CPE to immobilize the CI magnet. However, our data also demonstrated a significant scatter amongst different examiners. Although our data provide valuable data for potential clinical application, future development of the dressing technique is required for human use.
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Affiliation(s)
- Martin Leinung
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - Andreas G Loth
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Michaela Kroth
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Iris Burck
- Institute of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany
| | - Timo Stöver
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Silke Helbig
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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Liu P, Mu X, Zhang Q, Liu Z, Wang W, Guo W. Should compression bandage be performed after total knee arthroplasty? A meta-analysis of randomized controlled trials. J Orthop Surg Res 2020; 15:52. [PMID: 32059737 PMCID: PMC7023752 DOI: 10.1186/s13018-019-1527-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/18/2019] [Indexed: 12/02/2022] Open
Abstract
Background Compression bandage often is used after total knee arthroplasty (TKA) to alleviate pain, ameliorate swelling, and reduce bleeding. However, there is controversy about its application due to conflicting clinical outcomes and potential compression-related complications. This meta-analysis aimed to answer the question of if compression bandage should be implemented routinely after TKA. Methods Relevant randomized controlled trials (RCTs) on compression bandage were comprehensively retrieved utilizing search engines such as PubMed, EMBASE, Web of Science, and the Cochrane Library, up to September 2019. Studies included in the meta-analysis were those that compared post-operative pain score, swelling, total blood loss, pre- and post-operative hematocrit levels differences, range of motion (ROM), and complications, using Review Manager 5.3.0. Results Included were seven RCTs, which reported on 511 knees. The pooled results showed the compression bandage group was associated with a greater post-operative pain score during ambulation at 48 h (WMD = 0.70, 95% CI 0.07 to 1.34, P = 0.03), compared with the non-compression bandage group. No statistically significant differences were found between the groups in post-operative pain scores at the other times, swelling, blood loss, ROM, or other complications (P > 0.05). Conclusions The current evidence is unable to conclude that compression bandage is necessary after primary TKA. Surgeons routinely undertaking compression bandage should deliberate whether there is enough clinical evidence.
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Affiliation(s)
- Pei Liu
- Beijing University of Chinese Medicine, Yinghuadong Road, Chaoyang District, Beijing, China
| | - Xiaohong Mu
- Department Orthopedics 4, Beijing University of Chinese Medicine, Dongzhimen Hospital, Beijing, China
| | - Qidong Zhang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, China
| | - Zhaohui Liu
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, China
| | - Weiguo Wang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, China.
| | - Wanshou Guo
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, China.
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Cook L, Northgraves MJ, Fairhurst C, Ronaldson S, Torgerson DJ, Kent J, Reed M. Knee Replacement Bandaging Study (KReBS) evaluating the effect of a two-layer compression bandage system on knee function following total knee arthroplasty: study protocol for a randomised controlled trial. Trials 2019; 20:261. [PMID: 31068223 PMCID: PMC6505287 DOI: 10.1186/s13063-019-3344-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/03/2019] [Indexed: 11/24/2022] Open
Abstract
Background Data from a feasibility study suggest that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that may improve patient-reported health outcomes, and that it is feasible to recruit to a full-scale study. Methods We will conduct a randomised controlled trial (RCT) of 2600 adult patients, which has 80% power to detect a 1 point difference in the Oxford Knee Score (a patient self-reported assessment of knee pain and function) at 52 weeks. Short stretch compression bandaging will be compared with standard wool and crepe bandaging following total knee arthroplasty. Recruitment will take place in orthopaedic units across the United Kingdom. Secondary outcomes include the EuroQol 5 Dimensions (EQ-5D)-5 L and EQ-5D-3 L scores, pain, length of hospital stay, and complications. Discussion The Knee Replacement Bandaging Study (KReBS) is a large study which aims to contribute to the evidence base for informing clinical decisions for the use of compression bandaging following knee arthroplasty. Trial registration International Standard Randomised Controlled Trial Register, ISRCTN 87127065. Registered on 20 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3344-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liz Cook
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Matthew J Northgraves
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Sarah Ronaldson
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jonathan Kent
- Northumbria Healthcare NHS Foundation Trust and University of York, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, UK
| | - Mike Reed
- Northumbria Healthcare NHS Foundation Trust and University of York, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, UK
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8
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Brock TM, Sprowson AP, Muller S, Reed MR. STICKS study - Short-sTretch Inelastic Compression bandage in Knee Swelling following total knee arthroplasty - a feasibility study. Trials 2017; 18:6. [PMID: 28069060 PMCID: PMC5223465 DOI: 10.1186/s13063-016-1767-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postoperative knee swelling is common and impairs early postoperative function following total knee arthroplasty. It was hypothesised that the use of a short-stretch, inelastic compression bandage would reduce knee swelling and improve pain and early function. The aim of this study was to provide preliminary data and test feasibility with a view to informing a larger, future trial. METHODS Fifty consecutive patients selected for primary total knee arthroplasty underwent distance randomisation to receive a short-stretch, inelastic compression bandage or a standard wool and crepe bandage for the first 24 h postoperatively. Study feasibility including recruitment rates, retention rates and complications were analysed. The Oxford Knee Score, the EQ-5D-3L index score, knee swelling, knee range of motion, visual analogue pain score and length of stay were compared between groups. Analysis of covariance (ANCOVA) was performed adjusting for the preoperative measurement. RESULTS Sixty-eight percent of eligible patients were recruited into the trial. The retention rate was 88%. There were no complications regarding compression bandage use. There was a greater mean but non-significant improvement in Oxford Knee Score (p = 0.580; point estimate = 2.1; 95% CI -3.288 to 7.449) and EQ-5D-3L index score (p = 0.057; point estimate = 0.147; 95% CI -0.328 to 0.005) in the compression bandage group at 6 months. There was no significant difference between groups regarding knee swelling, knee range of motion, visual analogue pain score, complications and length of stay. CONCLUSION Preliminary data suggests that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that is acceptable to patients. A larger, multicentre trial is required to determine its effect postoperatively. TRIAL REGISTRATION The study was registered with Current Controlled Trials, identifier: ISRCTN86903140 . Registered on 30 May 2013.
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Affiliation(s)
- T M Brock
- Trauma and Orthopaedic Surgery, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
| | - A P Sprowson
- Trauma and Orthopaedics, Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK
| | - S Muller
- Wansbeck General Hospital, Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - M R Reed
- Wansbeck General Hospital, Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington, NE63 9JJ, UK
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9
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Folguera-Álvarez C, Garrido-Elustondo S, Verdú-Soriano J, García-García-Alcalá D, Sánchez-Hernández M, Torres-de Castro OG, Barceló-Fidalgo ML, Martínez-González O, Ardiaca-Burgués L, Solano-Villarrubia C, Lebracón-Cortés PR, Molins-Santos C, Fresno-Flores M, Cánovas-Lago MC, Benito-Herranz LF, García-Sánchez MT, Castillo-Pla O, Morcillo-San Juan MS, Ayuso-de la Torre MB, Burgos-Quintana P, López-Torres-Escudero A, Ballesteros-García G, García-Cabeza P, de Francisco-Casado MÁ, Rico-Blázquez M. ECAMulticapa: Effectiveness of double-layered compression therapy for healing venous ulcers in primary care: a Study Protocol. BMC Nurs 2016; 15:58. [PMID: 27752238 PMCID: PMC5059975 DOI: 10.1186/s12912-016-0179-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 09/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated. METHOD/DESIGN Randomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable. The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up. The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations. The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder. Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat. DISCUSSION The study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions. TRIAL REGISTRATION This study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.
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Affiliation(s)
- Carmen Folguera-Álvarez
- Centro de Salud La Paz, Atención Primaria, Servicio madrileño de Salud, Avenida Parque de Asturias s/n, Rivas-Vaciamadrid, 28523 Madrid Spain
| | - Sofia Garrido-Elustondo
- Red de investigación en Servicios de salud en enfermedades crónicas (REDISECC), Unidad de Apoyo a la Investigación, Gerencia de Atención Primaria Madrid, Calle Hacienda de Pavones, 271-28030 Madrid, Spain
| | - José Verdú-Soriano
- Facultad de Ciencias de la Salud, Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad de Alicante, Campus de San Vicente del Raspeig, AP 99, San Vicente del Raspeig, 03080 Alicante Spain
| | - Diana García-García-Alcalá
- Centro de Salud Villa de Vallecas, Atención Primaria. Servicio madrileño de Salud, Calle Fuentidueña, 12 28031 Madrid, Spain
| | - Mónica Sánchez-Hernández
- Hospital Puerta de Hierro Majadahonda, Servicio madrileño de Salud, Calle Joaquín Rodrigo 2, Majadahonda, 28222 Madrid Spain
| | - Oscar German Torres-de Castro
- Centro de Salud Federica Montseny, Atención Primaria, Servicio madrileño de Salud, Avenida de la Albufera, 285-28038 Madrid, Spain
| | - Maria Luisa Barceló-Fidalgo
- Centro de Salud Rafael Alberti, Atención Primaria, Servicio madrileño de Salud, Calle San Claudio 154 c/v León Felipe, 28038 Madrid, Spain
| | - Olga Martínez-González
- Centro de Salud Pavones, Atención Primaria, Servicio madrileño de Salud, Calle Hacienda de Pavones, 271-28030 Madrid, Spain
| | - Lidia Ardiaca-Burgués
- Centro de Salud La Paz, Atención Primaria, Servicio madrileño de Salud, Avenida Parque de Asturias s/n, Rivas-Vaciamadrid, 28523 Madrid Spain
| | - Carmen Solano-Villarrubia
- Dirección Asistencial Sureste, Atención Primaria, Servicio madrileño de Salud, Avenida de la Albufera, 285-28038 Madrid, Spain
| | - Pilar Raquel Lebracón-Cortés
- Centro de Salud Paracuellos del Jarama, Atención Primaria, Servicio madrileño de Salud, Calle Chorrillo Alta, 26-28860 Paracuellos del Jarama, Madrid Spain
| | - Carmen Molins-Santos
- Centro de Salud Buenos Aires, Atención Primaria, Servicio madrileño de Salud, Calle Pio Felipe, c/v Boada, c/v José Paulette, 28038 Madrid, Spain
| | - Mar Fresno-Flores
- Residencia San Fernando, Consejería de Bienestar Social, Calle Ventura de Argumosa 4, 28830 San Fernando de Henares, Madrid Spain
| | | | - Luisa Fernanda Benito-Herranz
- Centro de Salud Arganda, Atención Primaria, Servicio madrileño de Salud, Calle Camino del Molino s/n, 28500 Arganda del Rey, Madrid Spain
| | - Maria Teresa García-Sánchez
- Centro de Salud San Fernando II, Atención Primaria, Servicio madrileño de Salud, Plaza de Ondarreta, 28830 San Fernando de Henares, Madrid Spain
| | - Olga Castillo-Pla
- Centro de Salud Villablanca, Atención Primaria, Servicio madrileño de Salud, Calle Villablanca, 81 28032 Madrid, Spain
| | - María Sol Morcillo-San Juan
- Centro de Salud Villarejo de Salvanés, Atención Primaria, Servicio madrileño de Salud, Calle Hospital, 7-28590 Villarejo de Salvanés, Madrid Spain
| | - Maria Begoña Ayuso-de la Torre
- Centro de Salud Artilleros, Atención Primaria, Servicio madrileño de Salud, Paseo de los Artilleros s/n, 28032 Madrid, Spain
| | - Pilar Burgos-Quintana
- Centro de Salud Villa de Vallecas, Atención Primaria. Servicio madrileño de Salud, Calle Fuentidueña, 12 28031 Madrid, Spain
| | - Ana López-Torres-Escudero
- Centro de Salud Mejorada del Campo, Atención Primaria, Servicio madrileño de Salud, Calle Ciudad de Paris, 22-28840 Mejorada del Campo, Madrid Spain
| | - Gema Ballesteros-García
- Centro de Salud Torito, Atención Primaria, Servicio madrileño de Salud, Calle Camino de Vinateros, 140-28030 Madrid, Spain
| | - Piedad García-Cabeza
- Centro de Salud Jose María Llanos, Atención Primaria, Servicio madrileño de Salud, Calle Cabo Machichaco c/v, Cabo Tarifa, 28018 Madrid Spain
| | | | - Milagros Rico-Blázquez
- Unidad de Apoyo a la Investigación, Gerencia Asistencial de Atención Primaria de Madrid, Madrid, Spain
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10
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Abstract
In this review article the mechanisms of action of compression therapy are summarized and a survey of materials is presented together with some practical advice how and when these different devices should be applied. Some new experimental findings regarding the optimal dosage (= compression pressure) concerning an improvement of venous hemodynamics and a reduction of oedema are discussed. It is shown, that stiff, non-yielding material applied with adequate pressure provides hemodynamically superior effects compared to elastic material and that relatively low pressures reduce oedema. Compression over the calf is more important to increase the calf pump function compared to graduated compression. In patients with mixed, arterial-venous ulcers and an ABPI over 0.6 inelastic bandages not exceeding a sub-bandage pressure of 40 mmHg may increase the arterial flow and improve venous pumping function.
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Affiliation(s)
| | - Hugo Partsch
- emeritierter Vorstand der Dermatologischen Abteilung des Wilhelminenspitals, Medizinische Universität Wien, Wien, Österreich
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11
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Kröger K, Moerchel C, Santosa F. [Indications for compression therapy]. MMW Fortschr Med 2016; 158:70-72. [PMID: 27084168 DOI: 10.1007/s15006-016-8009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Knut Kröger
- Klinik für Gefäßmedizin, HELIOS Klinik Krefeld, Lutherplatz 40, D-47805, Krefeld, Deutschland.
| | | | - Frans Santosa
- Klinik für Gefäßmedizin, HELIOS Klinik Krefeld, Lutherplatz 40, D-47805, Krefeld, Deutschland
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12
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Vogler MC, De Pasquale V, Molliex S. [One case of perioperative rhabdomyolysis: don't forget the pathophysiology!]. ACTA ACUST UNITED AC 2014; 33:51-2. [PMID: 24373675 DOI: 10.1016/j.annfar.2013.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
Affiliation(s)
- M-C Vogler
- Département d'anesthésie-réanimation, CHU, 42055 Saint-Étienne cedex 2, France
| | - V De Pasquale
- Département d'anesthésie-réanimation, CHU, 42055 Saint-Étienne cedex 2, France
| | - S Molliex
- Département d'anesthésie-réanimation, CHU, 42055 Saint-Étienne cedex 2, France.
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