Efficacy of topical pale sulfonated shale oil in the treatment of venous leg ulcers: A randomized, controlled, multicenter study

Abstract

Pale sulfonated shale oils were capable of favoring venous ulcer healing in addition to compression therapy. PSSO should be considered for future wound care protocols for treatment of venous leg ulcers.

Midterm results with thoracic endovascular aortic repair for chronic type B aortic dissection with associated aneurysm

“…2 However, controversy exists with regard to the use of TEVAR for the management of chronic type B dissection with aneurysm. 8 Critics have cited the fact that the intimal flap becomes thickened in chronic dissections and does not immediately reapproximate to the native aortic wall, 9 as well as the fact that distal fenestrations between the true and false lumens become well established over time such that complete or near-complete false lumen thrombosis is less likely in the chronic setting. 4 For these reasons, the Society of Thoracic Surgeons Endovascular Surgery Task Force 4 gave TEVAR for chronic type B dissection a class IIb (efficacy not established) evidence rating.…”

Topical tar: Back to the future

“…51 It has since been used in the treatment of psoriasis, seborrheic dermatitis, and atopic dermatitis. 51,52 The anti-inflammatory effect of 4% shale oil is comparable with 0.5% hydrocortisone cream. 51 In a randomized, controlled, multicenter, observer-blinded trial of 119 patients evaluating the efficacy of PSSO in the treatment of venous leg ulcers, approximately half of the patients received a topical application of 10% PSSO to the site daily for 20 weeks, whereas the other half utilized a topical vehicle for the same time period.…”

“…However, there were no significant differences in granulation and complete epithelization at the end of the study period. 52 …”

The definition of the venous ulcer

“…12 Published studies that evaluate adjuvant therapies in venous ulcers, whether topical or systemic agents, or surgical procedures in conjunction with compression lack clarity in defining a chronic venous ulcer (grade: high-low, clinical randomized controlled trials and observational studies). [13][14][15][16][17][18][19][20][21] Several study examples will illustrate the significant variability of patients with CVU, inclusion criteria, and how CVU are defined. (1) In a large randomized trial evaluating compression plus surgery vs compression alone for CVU (ESCHAR study), the inclusion criteria were patients with venous ulcer (active or recently healed within 6 months) assessed by clinical examination and color venous duplex ultrasound scan, with ulcers located between the knee and malleoli, duration of 3 to 11 months, diameter of 1 to 5 cm, and an ankle-brachial index (ABI) of 0.85 or higher (grade: high, clinical randomized trial).…”

“…(6) In a randomized, observer blinded, multicenter study, pale sulfonated shale oil was evaluated as an adjunct to compression therapy in treating CVU (grade: low, single center clinical observational study). 19 Patients had clinical evaluations for venous disease and duplex ultrasound scan to confirm valvular reflux. The ABI was greater than 0.80, wound areas ranged from less than 20 cm 2 to greater than 35 cm 2 , and duration of ulcer from about 3 months to more than 70 months.…”