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Venous ulcers / edited by Cynthia K. Shortell, Jovan N. Markovic.
- Format:
- Book
- Language:
- English
- Subjects (All):
- Leg--Ulcers.
- Leg.
- Venous insufficiency.
- Venous Insufficiency.
- Varicose Ulcer.
- Varicose Veins.
- Medical Subjects:
- Venous Insufficiency.
- Varicose Ulcer.
- Varicose Veins.
- Physical Description:
- 1 online resource (568 pages)
- Edition:
- Second edition.
- Place of Publication:
- London, England : Academic Press, 2023.
- Summary:
- Venous Ulcers, Second Edition, provides a comprehensive synthesis of evidence-based recommendations and the highest level of expertise from a leading group of doctors, which is a fundamental constituent for the appropriate management of nonhealing venous wounds in everyday practice. This book offers a fertile environment for a complete understanding of genetics and molecular and biochemical mechanisms that lead to the development and progression of venous ulcers, which is essential for elucidating the underlying pathophysiology and can be utilized for developing novel therapies and accessing previously inaccessible areas of research. Socioeconomic impact, impact on health-related quality of life, the clinical course of the disease, and diagnostic algorithms are elaborated in detail. All currently available treatment modalities are explained in a clinically applicable approach with particular emphasis on operative technique, technical feasibility, success rates (both clinical and technical), and side effects. Lastly, this book elaborates on special diagnostic considerations and management of the most complex patients, often requiring the highest level of expertise for successful treatment.
- Contents:
- Front Cover
- Venous Ulcers
- Copyright
- Contents
- List of contributors
- Preface to Venous Ulcers
- 1 - Chronic venous insufficiency-basic considerations
- 1 - Pathophysiology of chronic venous disease: genetic, molecular, and biochemical mechanisms
- Key points
- Introduction
- Content
- Genetic predisposition for CVD and VLU
- Venous structure, endothelium and glycocalyx, inflammatory cells and molecules
- MMPs regulation, cellular changes, and CVD/VLU
- Structural proteins and alterations in CVD and VLU
- Microvenous valves and CVD
- Hypoxia, apoptosis, metabolic abnormalities, and connexins in CVD/VLU
- Machine learning GWAS and genetics, iron, oxidative stress, reactive oxygen/nitrogen species, biomarkers cytokines/proteoly ...
- Conclusions
- Acknowledgments
- References
- 2 - Venous hemodynamics and microcirculation in chronic venous insufficiency
- Hemodynamics and anatomy
- Pathophysiology-superficial venous incompetence
- Deep venous dysfunction
- Perforating veins of the calf
- Foot and calf pump function in venous hemodynamics
- Microcirculation and interstitial edema
- Regulation of capillary hydrostatic pressure
- Blood flow and inflammation
- 3 - Venous ulcers of the lower extremity: etiology, risks, and predictive factors
- CEAP etiologies of CVD
- Secondary etiologies
- Intravenous etiology
- Prospective natural history studies
- Epidemiologic studies
- Randomized trials of DVT treatment
- Extravenous etiology
- Epidemiological data on CVI and its progression
- The Edinburgh Vein Study50
- The San Diego population study51
- The Bonn Vein study52
- The Polish study64
- The French study53
- The Italian study54
- The American Venous Forum study55
- The Swedish Skaraborg County studies1,56,57.
- Progression of venous disease
- Clinical risk factors for first VLU (Table 3.5)
- Genetic risk factors for VLU
- Lymphatic involvement in VLU
- Summary
- 4 - Venous ulcers of the lower extremity: epidemiology and socioeconomic burden
- Role of epidemiology in the study and treatment of venous leg ulcers
- Incidence and prevalence of venous leg ulcers
- Distribution of chronic venous insufficiency and its subgroups within the population
- Defining venous leg ulcers
- Leg ulcer prevalence
- Etiologic spectrum of leg ulcers
- Venous ulcer prevalence
- Incidence of venous ulcers
- Age and sex distribution
- Socioeconomic aspects
- Venous ulcer natural history
- Obesity
- History of DVT
- Healing and survival
- Future trends
- 2 - Clinical evaluation and diagnostic modalities
- 5 - Initial clinical evaluation in patients with chronic venous insufficiency
- Medical history
- Risk factors
- Differential diagnosis of lower extremity ulcerations
- Symptoms of CVI
- History of prior VLU
- Past treatment history
- Physical exam
- Signs of CVI
- Assessment of the VLU
- Quality of life assessment
- Classification and venous severity scoring
- 6 - Ultrasound evaluation of lower extremity chronic venous disease
- Basic principles
- Diagnosis of reflux
- Superficial, deep, and perforator veins
- Examination protocol
- Diagnosis of obstruction
- Acute venous thrombosis
- Chronic venous obstruction
- Recurrent venous thrombosis
- Imaging during and after intervention
- Disclosure statement
- 7 - The diagnosis of major venous outflow obstruction in chronic venous insufficiency
- Iliac and pelvic veins anatomy and hemodynamics.
- Diagnosis of chronic venous insufficiency and venous hypertension
- History and physical
- Diagnostic modalities
- Arterial testing
- Duplex ultrasonography
- CT venography
- MRV
- Venography
- IVUS
- Diagnostic algorithm
- 8 - Hypercoagulable states associated with chronic venous insufficiency
- Protein C and protein S
- Antithrombin
- Factor V Leiden
- Activated protein C resistance
- Prothrombin G20210A gene mutations
- Dysfibrinogenemia
- Antiphospholipid syndrome
- Paroxysmal nocturnal hemoglobinuria
- Myeloproliferative neoplasms
- Other hypercoagulable states that increase the risk of developing VTE and potential subsequent venous ulceration
- Age
- Combined oral contraceptive pill and hormone replacement therapy
- Puerperium
- Cancer
- When and who to investigate?
- Thrombophilia and post-thrombotic syndrome
- Thrombophilia and venous ulceration
- 9 - The chronically swollen leg with ulcers-finding the cause: theory and practice
- Introduction and epidemiology
- Assessment of edema
- Physical examination
- Diagnostic studies
- Laboratory test
- Imaging
- Goals
- 10 - Lower extremity wounds associated with mixed venous and arterial insufficiency and relevant differential diagnosis
- Evaluation
- History and physical examination
- Vascular laboratory testing
- Arteriography
- Treatment
- Differential diagnosis
- Inflammatory ulcers
- Infectious ulcers
- Malignant ulcers
- Microvascular occlusive ulcers
- Pyoderma gangrenosum
- 11 - Assessment tools and wound documentation for patients with chronic venous insufficiency
- Wound assessment tools
- CEAP classification
- Venous Severity Score
- Revised Venous Clinical Severity Score
- Venous Segmental Disease Score
- Venous disability score
- Quality of life measures.
- QoL: SF-36
- QoL: Aberdeen Varicose Vein Questionnaire
- QoL: Chronic Venous Insufficiency Questionnaire
- QoL: VEINES-QoL/SYM
- QoL: Charing Cross Venous Ulcerations Questionnaire
- Wound documentation
- VLU measurements
- Imaging modalities for wound assessment and measurement
- Apps and cameras used for point-of-care wound measurements
- Point-of-care assessment of wound perfusion
- ABI, TCPO2, and SPY angiography
- Diagnosis and procedure codes
- 3 - Nonoperative management of chronic venous insufficiency and wound care
- 12 - Compression therapy in venous leg ulcers
- Compression devices
- Medical compression stockings
- Compression bandages
- Interface pressure and stiffness measured on the leg
- Elastic and inelastic bandages
- "Single-layer" and multilayer bandages
- Intermittent pneumatic compression
- Pelottes and pads
- Prevention of ulcer recurrence
- Compression techniques-practical guidelines
- 13 - Wound healing: adjuvant therapy and treatment adherance
- Patient and wound assessment
- Standard therapies for wound bed management
- General principles of wound bed management
- Wound bed preparation
- debridement and cleansing
- Debridement
- Sharp debridement
- Hydrosurgical debridement
- Enzymatic debridement
- Biologic debridement
- Cleansers and irrigation
- Pain management during wound bed preparation
- Wound dressings
- Interactive dressings: occlusive and semi-occlusive
- Wet-to-dry dressings
- Hydrogel dressings
- Hydrocolloid dressings
- Alginates
- hydrocellular foam dressings
- semipermeable film dressings
- Active (biologic) dressings
- Growth factor therapy
- Peri-wound management
- Adjuvant therapy for venous ulcer wound healing
- Skin grafting
- Ultrasound therapy
- Electrical stimulation.
- Optimizing care delivery
- Wound care clinics
- Adherence to therapy
- Treatment algorithm
- 14 - Negative pressure wound therapy for venous leg ulcers
- NPWT description and mechanism of action
- Use of NPWT in patients with VLUs
- Case study
- 15 - Medical therapies for chronic venous insufficiency
- Pathophysiology
- Lifestyle considerations
- Compression therapy
- Compression socks
- Inelastic compression garments
- Paste boots
- Multilayer compression bandages
- The bottom line on compression
- Pneumatic compression
- Dietary supplements
- Physical activity
- Medications
- Animal models
- Micronized purified flavonoid fraction
- Ruscus extract
- Calcium dobesilate
- Pentoxifylline and sulodexide
- Horse chestnut
- Acetylsalicylic acid
- Antibiotics
- Biologic wound care products
- Guidelines
- 16 - Treatment modalities for the management of nonhealing wounds in patients with chronic venous insufficiency
- Lifestyle modification
- Medical therapy
- Untreated arterial or deep venous disease
- Compression
- Identification and treatment of infection
- Dressings and local agents
- External stimulants
- Skin grafting, skin substitutes, and soft tissue substitutes
- Conclusion
- 17 - Deep vein thrombosis and prevention of postthrombotic syndrome
- Anatomic considerations in PTS
- Hemodynamics of PTS
- Collateralization and flow patterns in acute DVT
- Phlegmasia cerulea dolens
- Microcirculation and capillary exchange
- Anticoagulation to prevent PTS
- Venoactive drugs
- Elastic compression therapy
- Thrombolysis/endovascular therapies to prevent PTS
- Surgical thrombectomy
- Our experience
- A case study
- Open surgical reconstructions
- Ultrasound-accelerated thrombolysis.
- Venous ulcer care.
- Notes:
- Description based on print version record.
- Includes bibliographical references and index.
- Other Format:
- Print version: Shortell, Cynthia K. Venous Ulcers
- ISBN:
- 9780323906104
- 9780323985871
- 0323985874
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