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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2008 September;6(3):125-32
Microcirculation and venous leg ulcers
Apollonio A. 1, Mosti G. 2, Ricci E. 3
1 Unità Operativa di Angiologia Ospedale di Belcolle, Viterbo, Italia
2 Unità Operativa di Angiologia, Clinica M.D. Barbantini, Lucca, Italia
3 Unità Operativa Ferite Difficili Casa di Cura S. Luca, Pecetto Torinese Torino, Italia
Aim. The objective of this study was to gather information on the principal risk factors related to venous ulcers and to verify the role the microcirculation plays in healing by evaluating the efficacy of a systemic pharmacological therapy which compliments standard local treatment.
Methods. This study lasted for three months. A total of 338 patients (mean age 69.3 years, 65.1% females) were examined and given conventional treatment as well as an add-on systemic therapy consisting of phlebotonic or antithrombotic drugs for 12 weeks; for 86.7% of patients the systemic drug was sulodexide 500 LRU/day .
Results. The most prevalent risk factors were superficial venous insufficiency and incorrect plantar arch. It was discovered that if lesions lasted for over three months the levels of pain and disability increased significantly. Venous ulcers healed after 12 weeks of integrated treatment; the base of the ulcer and the presence of exudates were greatly improved; clear signs of ulcer healing. Pain intensity, measured on a visual analogue scale, fell drastically from an initial value of 6.3±2.2 to 3.6±2.0 after therapy, while 52.1% of patients had no pain again. The frequency of local medication was decidedly reduced.
Conclusion. Integrated treatment with drugs active on the microcirculation appears to reduce pain and accelerate the healing of venous ulcers, with obvious advantages for the patient and economic savings in the treatment of the disease.