Tanja Planinšek Ručigaj

Tanja Planinšek Ručigaj

University Clinical centre Ljubljana, Slovenia

Title: How to choose the propert dressings for venous leg ulcers



STUDY-1: Calcium-alginate with Mn,Zn/chlorophyllinis (Trionic®) used for fibrinous-wounds-bed. One half of 7venous ulcers was treated with alginate-Mn,Zn-dressing and the other half of the same ulcer with another alginate. Results:Half of the ulcer treated with alginate-Mn,Zn-dressing showed progress in100%wheather the other half of the same ulcer treated with another alginate showed progress in only28%. STUDY-2:Evaluated the effects of two alginate-dressings on the healing and pain during the treatment of 20v.ulcers. Results:Ulcers treated with alginate/silver(Silvercel®)were smaller for15,4%and ulcers treated with calcium-alginate were larger for0,7%.Pain was smaller at the patients treated with alginate/silver(begin:severe/end:no pain)compared to ulcers treated with alginate-dressings(beggin:severe/end:moderate). STUDY-3:To compare effects on healing and need for systemic-antibiotics at the 60v.ulcers by using honey-dressing (MelMax®) and silver/charcoal-dressing (Actisorb-plus®). Results:Mean wound-size at treating with honey-dressing was28cm² at the beginning and17cm² at the end.Mean wound-size at the treating with silver/charcoal-dressing was16cm² at the begin and15cm² at the end.Because of possible risk of systemic infection on day-1 swabs were taken from wound-bed from 9 patients,only 1 needed systemic-antibiotic after 1week of therapy with honey-dressings and all 6from whom swabs were taken from other group needed systemic-antibiotics. STUDY-4:To compare effects on healing of foam-dressing with silver(Contreet-H®)versus »local-best-practice« in the treatment of619ulcers with delayed healing. Results:Wound-area decreased faster in patient treated with foam-dressing/silver(50% vs. 34.3%reduction).The foam-dressing/silver significantly promotes positive wound progres in67%compared to51%using »local-best-practice«. STUDY-5:Impaired wound healing in 5chronic-wounds is associated with imbalance of excessive metalloproteases and inhibitors and higher level of bacteria who disturbing granulation-tissue formation.The dressing we used composed of collagen/oxidized-regenerated-cellulose/ionically-bound-silver(Promogran-Prisma®). Results:The whole ulcers-area were reduced for average34.11%per patient in17days. STUDY-6:Comparing the hydrofibre-dressing and ointments in changing microbial-colonisation and healing of 24 v.ulcers in 7weeks. Results:The most frequently isolated bacteria in group with hydrofibre-dressings(Aquacel®)was PseudomonasAeruginosa (begin:44.4%/end:20%)in group with ointment was most frequently Pseudomonas (begin:53.3%/end:60%).Mean wound-size at treating with hydrofibre-dressing was9.6cm² at the beginning and8.8cm² at the end.Mean wound-size at the treating with ointments was16.4cm² at the begin and19.5cm² at the end. STUDY-7:To evaluated effects on healing and pain in 5v.ulcers on Atrophie-blanche with using the hydrobalance-cellulose-dressings(Suprasorb-X®). Results:The average reduction in size of individual ulcer was9.6cm² in two-weeks. Pain was before therapy average:8 and at the end 0.2per patient. STUDY-8:The chronic pain was severe in 5patients with 7v.ulcer.The poliuretain-foam-dressings with analgesics(Biatain-Ibu®)were using to evaluate pain decreased. Results:The average-reduction of pain was from:8.4 to5.4per patient at the end. STUDY-9:Comparing increase of the skins-isles inside the 27v.ulcers with using and no using non-alcohol-film-forming-skin-protectant(Cavilon-spray®). Results:The ulcers area were reduced for15.55%in the ulcers treated with non-alcohol-film-forming-skin-protector and enlarged for1,12%at the other ulcers.The isles were lagered for two-times with non-alcohol-film-forming-skin-protector and reduced for13,8%at the ulcers withouth it. STUDY-10: 5 patients with not progress in healing venous leg ulcers for 5,2 years mean. At begin were in stage C3 and size was 24,44 cm² mean. Foam AMD with PHMB® changed every 3-4 days. The treatment last mean 44,7 days or until wound did not healed. Results: One wound healed. The other were smaller and measurement at the end 17,69 cm² mean. The wound beds were in a stage A2. STUDY-11: To evaluated effects on healing and pain in 14 C2-3 VLU treating with honey (Vivmel®- group 1) and 16 C3 VLU treating with antiseptic (AMD with PHMB® - group 2). Results: In group1 were results on healing fasters (after one week), but in group 2 were no pain than there were at group1. After two weeks all the VLU from both group were B2 by Falanga 's clssification.