Contemporary treatment of venous lower limb ulcers. 1992

W R Hiatt
Section of Vascular Medicine, University of Colorado School of Medicine, Denver.

The postphlebitic syndrome is a significant management problem that affects a large number of patients. Primary prophylaxis of deep-vein thrombophlebitis would reduce the risk of developing the postphlebitic syndrome and should be considered in high-risk patients. Patients who have had a phlebitis should be monitored with noninvasive tests of the deep venous circulation for the development of venous valve incompetence. Patients with venous hypertension should be placed in compression stockings to prevent the postphlebitic syndrome. In patients who progress to venous ulceration, several aggressive measures must be undertaken. Systemic treatment includes management of obesity, edema, immobility, poor nutrition, and comorbid illnesses. Some patients may require a short hospitalization of bed rest, lower limb elevation, and daily dressings and wound care. Outpatient therapy requires sustained compression of 35 to 40 mmHg at the ankle for many months to allow the ulcer to heal. The standard bandage material is Unna's boots, which is applied every one to two weeks by a trained nurse. Cadexomer iodide is an effective local treatment that helps debride the ulcer and accelerate healing. Finally, pentoxifylline therapy has also been shown to significantly improve the healing of venous ulcers.

UI MeSH Term Description Entries
D007455 Iodine A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. Iodine-127,Iodine 127
D007466 Iodophors Complexes of iodine and non-ionic SURFACE-ACTIVE AGENTS acting as carrier and solubilizing agent for the iodine in water. Iodophors usually enhance bactericidal activity of iodine, reduce vapor pressure and odor, minimize staining, and allow wide dilution with water. (From Merck Index, 11th ed) Tamed Iodine,Iodine, Tamed
D008863 Microspheres Small uniformly-sized spherical particles, of micrometer dimensions, frequently labeled with radioisotopes or various reagents acting as tags or markers. Latex Beads,Latex Particles,Latex Spheres,Microbeads,Bead, Latex,Beads, Latex,Latex Bead,Latex Particle,Latex Sphere,Microbead,Microsphere,Particle, Latex,Particles, Latex,Sphere, Latex,Spheres, Latex
D011186 Postphlebitic Syndrome A condition characterized by a chronically swollen limb, often a leg with stasis dermatitis and ulcerations. This syndrome can appear soon after phlebitis or years later. Postphlebitic syndrome is the result of damaged or incompetent venous valves in the limbs. Distended, tortuous VARICOSE VEINS are usually present. Leg pain may occur after long period of standing. Postphlebitic Disease,Postphlebitic Ulcer,Disease, Postphlebitic,Diseases, Postphlebitic,Postphlebitic Diseases,Postphlebitic Syndromes,Postphlebitic Ulcers,Syndrome, Postphlebitic,Syndromes, Postphlebitic,Ulcer, Postphlebitic,Ulcers, Postphlebitic
D004337 Drug Carriers Forms to which substances are incorporated to improve the delivery and the effectiveness of drugs. Drug carriers are used in drug-delivery systems such as the controlled-release technology to prolong in vivo drug actions, decrease drug metabolism, and reduce drug toxicity. Carriers are also used in designs to increase the effectiveness of drug delivery to the target sites of pharmacological actions. Liposomes, albumin microspheres, soluble synthetic polymers, DNA complexes, protein-drug conjugates, and carrier erythrocytes among others have been employed as biodegradable drug carriers. Drug Carrier
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001458 Bandages Material used for wrapping or binding any part of the body. Dressings,Bandage,Dressing
D017613 Iodine Compounds Inorganic compounds that contain iodine as an integral part of the molecule. Compounds, Iodine

Related Publications

W R Hiatt
May 2014, Revista de enfermeria (Barcelona, Spain),
W R Hiatt
January 2009, Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery,
W R Hiatt
May 2010, Journal of vascular and interventional radiology : JVIR,
W R Hiatt
January 2003, Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery,
W R Hiatt
May 2012, Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India,
W R Hiatt
September 2014, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery,
W R Hiatt
January 2011, Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery,
W R Hiatt
March 2012, Clinical and experimental medicine,
W R Hiatt
December 2014, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery,
Copied contents to your clipboard!