Dressings and topical agents for arterial leg ulcers

Broderick, Cathryn; Pagnamenta, Fania; Forster, Rachel

doi:10.1002/14651858.cd001836.pub4

Cited by 17 publications

(23 citation statements)

References 59 publications

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“…In a review of the Cochrane database, updated in 2020, no evidence that topical agents or dressings can influence the healing of arterial ulcers was retrieved. 22 …”

Section: Arterial Ulcersmentioning

confidence: 99%

Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology

Abbade

Frade

Pegas³

et al. 2020

Anais Brasileiros de Dermatologia

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Background Chronic leg ulcers affect a large portion of the adult population and cause a significant social and economic impact, related to outpatient and hospital care, absence from work, social security expenses, and reduced quality of life. The correct diagnosis and therapeutic approach are essential for a favorable evolution. Objective To gather the experience of Brazilian dermatologists, reviewing the specialized literature to prepare recommendations for the diagnosis and treatment of the main types of chronic leg ulcers. Methods Seven specialists from six university centers with experience in chronic leg ulcers were appointed by the Brazilian Society of Dermatology to reach a consensus on the diagnosis and therapeutic management of these ulcers. Based on the adapted DELPHI methodology, relevant elements were considered in the diagnosis and treatment of chronic leg ulcers of the most common causes; then, the recent literature was analyzed using the best scientific evidence. Results The following themes were defined as relevant for this consensus - the most prevalent differential etiological diagnoses of chronic leg ulcers (venous, arterial, neuropathic, and hypertensive ulcers), as well as the management of each one. It also included the topic of general principles for local management, common to chronic ulcers, regardless of the etiology. Conclusion This consensus addressed the main etiologies of chronic leg ulcers and their management based on scientific evidence to assist dermatologists and other health professionals and benefit the greatest number of patients with this condition.

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“…In a review of the Cochrane database, updated in 2020, no evidence that topical agents or dressings can influence the healing of arterial ulcers was retrieved. 22 …”

Section: Arterial Ulcersmentioning

confidence: 99%

Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology

Abbade

Frade

Pegas³

et al. 2020

Anais Brasileiros de Dermatologia

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“…52 Furthermore, there are a variety of guidelines depending on a chronic wound's aetiology (arterial, venous, diabetic foot and pressure ulcers), and a lack of evidence for woundhealing products' efficacy, as demonstrated by a series of inconclusive Cochrane reviews. [53][54][55][56][57][58][59] National guidelines are necessary to support wound teams 60 , and our results highlight their absence in Switzerland.…”

Section: Multidisciplinary Wound Centre Development Needsmentioning

confidence: 64%

Survey of physicians’ and nurses’ needs and expectations regarding a multidisciplinary wound clinic

2021

JOWM

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To describe needs and expectations from healthcare professionals while setting up a multidisciplinary wound clinic. MethodsAn online survey was conducted in a 190-bed hospital in Western Switzerland from the 2nd to 15th of June 2020. Descriptive statistics were used to analyse the data. ResultsA total of 166 healthcare professionals (118 nurses, 48 physicians) participated in the survey. Half of the participants (48%) saw the importance of setting up a wound clinic as 47% were taking care of wounds daily. Almost all participants (83 %) disclosed having no educational wound care background and half of them (54%) indicated having no skills and knowledge in wound management. The main aetiologies treated in a specialist center should be diabetic foot, leg and pressure ulcers, then malignant wounds. It is expected a specialist clinic cares for complex or nonhealing wounds. Furthermore, 48% of participants wished a multidisciplinary expert approach with a common protocol to guarantee a continuity of care. The wound center should also have an educational role, essential in maintaining up-to-date practice. Conclusions and implications for clinical practiceIn conclusion, a wound clinic should have a multidisciplinary specialist approach while ensuring evidence-based and uniform practices to provide a person-centered care. Furthermore, further-education must be offered.

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“…It is important to declare that the decision to use ketanserin gel is based on its wide commercial availability in our country and on the experience obtained in the treatment of vascular and diabetic ulcers; however, a recent Cochrane meta-analysis 17 showed inconclusive results regarding its effectiveness compared to that of other substances. Since other topical agents, such as petroleum jelly and silver sulphadiazine, have also been described for the conservative management of fingertip amputations, 6 we believe the results shown in the present study cannot be directly related to ketanserin, but to a microenvironment rich with the proper growth factor, humidity control, and hygiene obtained through a close follow-up and early interventions, as needed.…”

Section: Discussionmentioning

confidence: 99%

“…É importante salientar que a decisão de usar o gel de ketanserina é baseada na ampla disponibilidade comercial em nosso país e na experiência obtida no tratamento de úlceras vasculares e diabéticas. Entretanto, uma recente metanálise da Cochrane 17 apresentou resultados inconclusivos sobre sua eficácia em comparação com outras substâncias. Uma vez que outros agentes tópicos, como a vaselina e a sulfadiazina de prata, também foram descritos para o tratamento conservador da amputação da ponta do dedo, 6 acreditamos que os resultados demonstrados no presente estudo não podem depender diretamente da ketanserina, mas de um microambiente rico em fator de crescimento adequado, controle de umidade e higiene, obtidos por meio de um acompanhamento atento e de intervenções precoces, quando necessário.…”

Section: Discussionunclassified

Análise comparativa de um protocolo de cicatrização secundária modificado para amputações das pontas dos dedos e técnicas de reconstrução não microcirúrgicas

Chavez-Galvan

Martínez-Pérez

Flores-Álvarez³

et al. 2021

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Descrever e comparar os resultados obtidos com um protocolo de cicatrização secundária para amputações das pontas dos dedos e sua relação com a gravidade da lesão de acordo com a classificação de Allen. Métodos Foram revisados os prontuários clínicos de 127 lesões nas pontas dos dedos, e realizou-se um estudo retrospectivo, comparativo e analítico das amputações tratadas de forma conservadora. Foram descritas e analisadas as características da lesão, o tempo de cicatrização, e as complicações. Resultados Entre abril de 2017 e maio de 2019, foram tratadas de forma conservadora 127 lesões nas pontas dos dedos. A idade média da amostra era de 28,33 anos. O tempo médio de cicatrização foi de 4,31 semanas. As complicações apresentadas durante o acompanhamento afetaram 18,9% (n = 24) dos casos, porém nenhum exigiu tratamento de revisão. Não foi encontrada relação estatisticamente significativa entre o desenvolvimento das complicações e a revisão do tratamento de acordo com a classificação de Allen (p ≥ 0,05). Conclusão O protocolo de cicatrização secundária proposto mostrou-se seguro e eficaz nas amputações das pontas dos dedos conforme os tipos de 1 a 3 da classificação de Allen, e deve ser incluída como opção terapêutica mesmo em lesões de maior extensão do que aquelas tradicionalmente limitadas.

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Dressings and topical agents for arterial leg ulcers

Cited by 17 publications

References 59 publications

Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology

Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology

Survey of physicians’ and nurses’ needs and expectations regarding a multidisciplinary wound clinic

Análise comparativa de um protocolo de cicatrização secundária modificado para amputações das pontas dos dedos e técnicas de reconstrução não microcirúrgicas

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