Single-visit venous ulcer assessment clinic: The first year

Scriven, J. M.; Hartshorne, T.; Bell, P. R. F.; Naylor, A.R.; London, N. J. M.

doi:10.1046/j.1365-2168.1997.02559.x

Cited by 27 publications

(35 citation statements)

References 7 publications

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“…In the present study, in 40 patients diagnosed with chronic venous ulcers (CVU), the concomitant presence of peripheral arterial disease (PAD) was detected in 10 (25%) of them by means of ABI; this ratio was lower than that described by Nelzen (40%), 4 but higher than those reported by Anderson (24.5%), 12 Scriven (14%) 11 and Callam (21%). 13 Thus, it could be stated that the detection of concomitant chronic venous ulcers (CVU) and peripheral arterial disease (PAD) was frequent in the population studied.…”

Section: Resultscontrasting

confidence: 45%

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Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica

Bergonse

Rivitti

2006

An. Bras. Dermatol.

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BACKGROUND -Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES -Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS -Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS -The resting ankle/brachial pressure index was abnormal (lower than 1) in 9/22 (40.9%) patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7%) patients with chronic venous ulcers and no hypertension. CONCLUSIONS -Patients with concomitant chronic venous ulcer and hypertension should be routinely evaluated with the ankle/brachial pressure index to detect a possible association with peripheral arterial disease. Keywords: Arterial occlusive diseases; Ultrasonography, doppler; Varicose ulcer Resumo: FUNDAMENTOS -As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS -Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS -Foram estudados

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Section: Resultscontrasting

confidence: 45%

“…10 Nelzen, 4 in a population study, found an ABI< 0.9 in 185 (40%) leg ulcers and Scriven, 11 in 14% of leg ulcers.…”

Section: Resultsmentioning

confidence: 99%

Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica

Bergonse

Rivitti

2006

An. Bras. Dermatol.

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“…It is estimated that around half of venous leg ulcers have a surgically treatable cause and treatment of the underlying venous disease offers one way to reduce the recurrence rate. 10 The majority of patients referred with varicose veins are found to have uncomplicated truncal venous disease (CEAP C2). If a policy of not offering NHS treatment for cosmetic varicose veins is adopted, the surgical removal of superficial veins is only indicated for the subgroup of patients with functional superficial venous reflux that is a major contributor to the venous dysfunction, clinical symptoms and chronic venous ulcers.…”

Section: Discussionmentioning

confidence: 99%

A Study of the Routine Use of Venous Photoplethysmography in a One-Stop Vascular Surgery Clinic

Beraldo

Satpathy

Dodds

2007

annals

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INTRODUCTION The decision to offer surgical treatment for varicose veins should be based on objective evidence of venous dysfunction and not only the subjective appearance or the reported symptoms. Special tests are required to identify the subgroup of patients with functional superficial venous reflux accurately. The initial test should be simple, cheap, objective, sensitive and easy to perform by a wide range of staff in order to screen out patients without reflux. The final test should be anatomically specific to identify the appropriate surgical procedure. The aim of this study was to test the feasibility of using photoplethysmography (PPG) as the initial test as part of a one-stop vascular clinic assessment protocol.PATIENTS AND METHODS All patients referred to one consultant over a 68-week period were assessed using standard practice for the first 22 weeks and with an objective assessment protocol based on PPG for the subsequent 46 weeks. RESULTS A total of 347 out-patient appointments for patients with venous disease were booked: 239 (69%) were new referrals. Of the new patients, 59% were CEAP C2/3 and 23% were CEAP C4-6. The introduction of the objective assessment protocol was associated with a reduction in patients offered surgery from 39% to 24% overall and 51% to 28% in new patients with CEAP C2. There was a corresponding increase in the number of patients discharged back to the GP from 19% to 29% overall and 17% to 32%, respectively. The number of patients referred for duplex ultrasound fell slightly from 26% to 22%. Overall, there was a significant change in practice between the two periods ( χ 2 = 13.3; df = 3; P = 0.004).CONCLUSIONS The introduction of an objective assessment protocol based on PPG as the initial objective test reduces the number of patients offered surgery based on objective evidence of venous dysfunction.

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“…In spite of a wide range of etiological factors, the main causes of lower limb chronic ulcers are venous and arterial diseases; in that, 60 to 70% being caused by venous problems, the so-called venous ulcer 6,7 , and 10 to 25% by arterial insufficiency, that may coexist with venous disease (mixed ulcer). 8 In about 3.5% of patients, the cause is not identified.…”

Section: Diagnostic Managementmentioning

confidence: 99%

Abordagem de pacientes com úlcera da perna de etiologia venosa

Abbade

Lastória

2006

An. Bras. Dermatol.

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Venous ulcers are common in adult population. They cause significant socioeconomic impact due to recurrence and the long interval between onset and healing. If venous ulcers are not appropriately managed, they present high rates of healing failure and recurrence. Despite their high prevalence and importance, venous ulcers are often neglected and inadequately managed. This review discusses diagnosis and therapy of lower limb venous ulcers. Clinical diagnosis is based on history and physical examination, emphasizing associated signs and symptoms, and pulse palpation of lower limbs. Doppler must be used to determine the ankle-arm index, and non-invasive exams, such as duplex scan, are requested to evaluate the superficial, deep and perforating venous systems. Accurate clinical and laboratory diagnosis of venous ulcers, as well as appropriate treatment of their complications are fundamental for successful therapy. Efforts must be directed towards healing and avoiding recurrences.

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Single-visit venous ulcer assessment clinic: The first year

Abstract: In this clinic 14 per cent of leg ulcers had a significant arterial component and over half of venous ulcers may benefit from superficial venous surgery. In many ulcerated limbs, clinical assessment alone is inadequate to detect superficial reflux or previous deep vein thrombosis.

Cited by 27 publications

References 7 publications

Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica

Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica

A Study of the Routine Use of Venous Photoplethysmography in a One-Stop Vascular Surgery Clinic

Abordagem de pacientes com úlcera da perna de etiologia venosa

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