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A Journal on Phlebology
Acta Phlebologica 2010 April;11(1):17-21
Treatment of venous ulcers with LMWH: effects on healing rate, pain and quality of life
Department of Vascular Surgery and Pathology, Istituto Dermopatico dell’Immacolata (IDI-IRCCS), Rome, Italy
AIM: The aim of this study was to determine the effect of low-molecular-weight heparin (LMWH) on venous ulcer healing and associated pain and quality of life.
METHODS: Patients affected by chronic venous ulcers (CVU, N.=97) were randomised to the control group (N.=45) receiving standard treatment: wound cleansing, debridement and short stretch compression bandaging, or the nadroparin group (N.=52) receiving standard treatment plus systemic LMWH (nadroparin, Seleparina, Italfarmaco, Milan, Italy) administered by subcutaneously (5 700 U/day; 3 800 U/day in patients <50 kg) for 28 days. Ulcer area was measured by planimetry, pain with a visual analogue scale (VAS) and health-related quality of life with the SF-12 questionnaire.
CONCLUSION: Nadroparin plays an important adjuvant role in venous ulcer treatment because it favours pain relief and improves quality of life.
RESULTS: Mean ulcer surface area decreased in both groups (from 22.04 cm2 to 8.46 cm2 in the nadroparin group, from 20.36 cm2 to 11.19 cm2 in the control group), though the difference between groups was not statistically significant (P=0.1377). Reduction of mean pain score at dressing change was significantly greater in the nadroparin group (from 7.23 to 3.48 in the nadroparin group vs. from 6.29 to 4.20 in the control group, P=0.0011). There were no significant differences between groups for diurnal or nocturnal pain. Improvements in SF-12 physical and mental indices were significantly greater in the nadroparin group: improvement in the mean physical index was 5.76 compared to 2.61 for the control group, while the mean mental index improved by 6.81 compared to 3.65 in the control (P<0.05).