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Copyright (c) 2021 Adriana Patricia Bulla Silva, Nataly Johana Espitia Suárez, Diana Carolina Vargas Quintero, Ledmar Jovanny Vargas Rodríguez
This work is licensed under a Creative Commons Attribution 4.0 International License.
Characteristics of patients with recurrence of ulcer due to chronic venous insufficiency in patients
Corresponding Author(s) : Ledmar Jovanny Vargas Rodríguez
Ciencia e Innovación en Salud,
2021
Abstract
Background: Chronic venous disease is a pathology derived from anatomical or functional alterations of the venous system. The objective of this study was to determine the characteristics of patients with recurrence of ulcer due to chronic venous disease in users of the clinical wound program of a tertiary hospital in Tunja. Methods: A descriptive, retrospective and cross-sectional study was carried out in the period 2017 to 2019, which included patients older than 18 years of age with a diagnosis of vascular ulcer due to chronic venous disease. Results: The prevalence of recurrence was 15.7%. The mean age of the participants was 65 years, where 72.7% were women and 77.3% of the participants lived alone. Hypertension (72.7%) and overweight (45.5%) were the comorbidities that occurred with the highest frequency. The lower limb most affected was the left with 68.2%. People spent 50.9 minutes a day with the limb elevated and 6.6 hours a day in a standing position. Conclusions: The prevalence of ulcer recurrence due to chronic venous disease in the present study is lower than that reported in the literature, where the female population, 65 years of age, is affected, associated with multiple comorbidities such as overweight, malnutrition, smoking, dyslipidemia, among others. It most frequently affects the lower left limb and the most commonly used procedures are surgical (varicosafenectomy) and medium and high pressure compression therapy. Based on this study, other institutions are invited to evaluate wound management programs in order to analyze the impact and learn about this population group.
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- Adela Emilia Gómez Ayala. Úlceras vasculares. Factores de riesgo, clínica y prevención. 2008; 22 (6): 33-38. https://www.elsevier.es/es-revista-farmacia-profesional-3-articulo-ulceras-vasculares-factores-riesgo-clinica-13124067
- Miquel Abbad C., Rial Horcajo R., Ballesteros Ortega M.D. & García Madrid C. (2015) Guías de Práctica Clínica en Enfermedad Venosa Crónica. https://medes.com/publication/107046
- Espejel Blancas J.A. et. (2018) Enfermedad venosa crónica y enfermedad hemorroidal en México. Revista México Angiología. 46(4): 204-212
- Vázquez Hernández I. & Acevedo Peña M. Prevalencia de enfermedad venosa periférica en el personal de enfermería. Enfermería Universitaria. 2016; 13(3):166-170. DOI: 10.1016/j.reu.2016.05.003
- Carrasco Carrasco E. & Díaz Sánchez S. Recomendaciones para el manejo de la Enfermedad Venosa Crónica en Atención Primaria. Semergen. 2015; 15 (2): 23 – 28.
- https://www.semfyc.es/grupos/recomendaciones-para-el-manejo-de-la-enfermedad-venosa-cronica-en-atencion-primaria/
- Coccheri S., Mannello F. Development and use of sulodexide in vascular diseases: implications for treatment. Drug Design, development in therapy 2014; 4: 49-65. DOI: 10.2147/DDDT.S6762
- Escudero J.R., Fernández F., Belmunt S. Prevalencia y características clínicas de la
- enfermedad venosa crónica en pacientes atendidos en Atención Primaria en España: resultados del estudio internacional Vein Consult Program. Cir Esp. 2014;92 (8):539–546. https://medes.com/publication/92815
- Pannier F, Rabe E. Differential diagnosis of leg ulcers. Phlebology 2012; 28(1):55-0. DOI:10.1177/0268355513477066
- World Health Organization. Management of substance abuse [Internet].[Consultado 2014 May 12]. http://www.who.int/substance_abuse/research_tools/whoqolbref/en/
- Rusbert Fernando Álvarez Del Río. Factores asociados a la Cicatrización de Úlceras Venosas de Miembros Inferiores y Calidad de Vida en Adultos, Medellín 2014-2015. Tesis. Facultad Nacional de Salud Pública Héctor Abad Gómez Medellín 2015. http://bibliotecadigital.udea.edu.co/handle/10495/3565
- Secretaría de Salud. Guía de práctica clínica. Prevención, diagnóstico y tratamiento de la enfermedad venosa crónica. México: CENETEC; 2009
- Espinóla CF, Bernau M, Aucejo M, et al. Prevalencia de várices en miembros inferiores en el personal del Hospital de Clínicas. Rev Chil Cir. 2007;59:342---7
- Marques de Souza E, Bonetti Yoshida W, Aragao de Melo V, Bitencurt de Oliveir L. Ulcer Due to Chronic Venous Disease: A Sociodemographic Study in Northeastern Brazil Annals of Vascular Surgery. 2013;27:571-6. DOI: 10.1016/j.avsg.2012.07.021
- Karanikolic V, Karanikolic A, Petrovic D, Stanojevic M. Prognostic factors related to delayed healing of venous leg ulcer treated with compression therapy. Dermatologica Sinica. 2015;33(4):206-9. DOI: 10.1016/j.dsi.2015.04.005
- Moffatt CJ, Franks PJ, Doherty DC, Smithdale R, Martin R. Sociodemographic factors in chronic leg ulceration. Br J Dermatol 2006; 155(2):307-12. DOI: 10.1111/j.1365-2133.2006.07265.x
- Gabriela Otero González*, Caroline Agorio Norstrom† , Miguel Martínez Asuaga. Úlceras de miembros inferiores Características clínico-epidemiológicas de los pacientes asistidos en la unidad de heridas crónicas del Hospital de Clínicas. Rev Méd Urug 2012; 28(3): 182-189. http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-03902012000300004
- Labropoulos N, Wang E, Lanier S, Khan S. Factors Associated with Poor Healing and Recurrence of Venous Ulceration Plastic and Reconstructive Surgery 2012:179-86.
- DOI: 10.1097/PRS.0b013e3182362a53
- Haughey L, Barbul A. Nutrition and Lower Extremity Ulcers: Causality and/or Treatment. Int J Low Extrem Wounds. 2017 Dec;16(4):238-243. DOI: 10.1177/1534734617737639.
- Juárez-Cedillo, T. Changes in nutritional needs with aging. In: Watson, RR ed. Nutritional and Functional Foods for Healthy Aging. San Diego, CA: Academic Press; 2017:27-41.
- Langer, G, Fink, A. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2014;(6):CD003216. DOI: 10.1002/14651858.CD003216.pub2
- I. Vázquez-Hernández ∗ y M. Acevedo-Pena. Prevalencia de enfermedad venosa periférica en el personal de enfermería. Enfermería Universitaria. 2016;13(3):166-170. DOI: 10.1016/j.reu.2016.05.003
- Vuylsteke M, Thomis S, Guillaume G, Modliszewski M, Weides N, Staelens I. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. European Journal Of Vascular And Endovascular Surgery: The Official Journal Of The European Society For Vascular Surgery. 2015; 49(4):432-9. DOI: 10.1016/j.ejvs.2014.12.031
- Vlajinac H, Marinkovic J, Maksimovic M, Radak D. Factors Related To Venous Ulceration: A Cross-Sectional Study. Angiology. 2014; 65(9):824-30. DOI: 10.1177/0003319713508218
- Robertson L, Lee AJ, Gallagher K, Carmichael SJ, Evans CJ, McKinstry BH, et al. Risk factors for chronic ulceration in patients with varicose veins: A case control study. J Vasc Surg 2009; 49:1490-8. DOI: 10.1016/j.jvs.2009.02.237
- Alguire P, Mathes B. Clinical manifestations of lower extremity chronic venous disease. Uptodate. 2014:1-15.
- Ribu L, Birkeland K, Hanestadc B, Moumd T, Rustoen T. A longitudinal study of patients with diabetes and foot ulcers and theirhealth-related quality of life: wound healing and quality-of-life changes. Journal of Diabetes and Its Complications. 2008; 22:400-7. DOI: 10.1016/j.jdiacomp.2007.06.006
- Kantor J, Margolis DJ. Management of leg ulcers. Semin Cutan Med Surg 2003; 22(3):212-21.
- Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: a consensus statement (France, March 5-9, 1997). Circulation 2000; 102(20):E126-63.
- Lozano F. Origen del síndrome de la clase turista: John Homans 2016;68(3):255-256. DOI: 10.1016/j.cger.2013.01.006
- Thomas D. Managing Venous Stasis Disease and Ulcers. Clinical geriatric medicine. 2013;29:415-24. DOI: 10.1016/j.cger.2013.01.006
- Carreño Ávila P. Terapéutica de la Compresión en el tratamiento de la úlcera de etiología venosa. Todoheridas. 2010;1(1):4-16. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2018000300153
- Mauck K, Asi N, Elraiyah T, Undavalli C, Nabhan M, Altayar O, et al. Comparative systematic review and meta-analysis of compression modalities for the promotion of venous ulcer healing and reducing ulcer recurrence. J Vasc Surg. 2014;60(2, Supplement):71-90. 68. DOI: 10.1016/j.jvs.2014.04.060
- Thomas F. O’Donnell Jr, MD, Marc A. Passman, MD, William A. Marston, MD, William J. Ennis, DO, Michael Dalsing, MD, Robert L. Kistner. Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery_ and the American Venous Forum. Journal vascular surgery. 2014; Volume 60, Number 2S: 3S-57S. DOI: 10.1016/j.jvs.2014.04.049
- Brölmann FE, Ubbink DT, Nelson EA, Munte K, van der Horst CMAM, Vermeulen H. Evidence-based decisions for local and systemic wound care. Br J Surg 2012;99(9):1172- 83.
- Dumville JC, Deshpande S, O'Meara S, Speak K. Hydrocolloid dressings for healing diabetic foot ulcers. The Cochrane database of systematic reviews. 2013;8:Cd009099.
- DOI: 10.1002/bjs.8810
- Palfreyman S, Nelson EA, Michaels JA. Dressings for venous leg ulcers: systematic review and meta-analysis. BMJ (Clinical research ed). 2007; 335(7613):244.). DOI: 10.1136/bmj.39248.634977.AE
- Serra R, Grande R, Butrico L, et al. Effects of a new nutraceutical substance on clinical and molecular parameters in patients with chronic venous ulceration. Int Wound J 2016;13:88–96. DOI: 10.1111/iwj.12240
- Raffetto JD. Pathophysiology of wound healing and alterations in venous leg ulcers- review. Phlebology 2016;31(1 Suppl):56–62. DOI: 10.1177/0268355516632998
- Kurz X, Lamping D, Kahn S, Baccaglini U, Zuccarelli F, Spreafico G, et al. Do varicose veins affect quality of life? Results of an international population-based study. J Vasc Surg 2001; 34(4):641-8. DOI: 10.1067/mva.2001.117333
References
Adela Emilia Gómez Ayala. Úlceras vasculares. Factores de riesgo, clínica y prevención. 2008; 22 (6): 33-38. https://www.elsevier.es/es-revista-farmacia-profesional-3-articulo-ulceras-vasculares-factores-riesgo-clinica-13124067
Miquel Abbad C., Rial Horcajo R., Ballesteros Ortega M.D. & García Madrid C. (2015) Guías de Práctica Clínica en Enfermedad Venosa Crónica. https://medes.com/publication/107046
Espejel Blancas J.A. et. (2018) Enfermedad venosa crónica y enfermedad hemorroidal en México. Revista México Angiología. 46(4): 204-212
Vázquez Hernández I. & Acevedo Peña M. Prevalencia de enfermedad venosa periférica en el personal de enfermería. Enfermería Universitaria. 2016; 13(3):166-170. DOI: 10.1016/j.reu.2016.05.003
Carrasco Carrasco E. & Díaz Sánchez S. Recomendaciones para el manejo de la Enfermedad Venosa Crónica en Atención Primaria. Semergen. 2015; 15 (2): 23 – 28.
Coccheri S., Mannello F. Development and use of sulodexide in vascular diseases: implications for treatment. Drug Design, development in therapy 2014; 4: 49-65. DOI: 10.2147/DDDT.S6762
Escudero J.R., Fernández F., Belmunt S. Prevalencia y características clínicas de la
enfermedad venosa crónica en pacientes atendidos en Atención Primaria en España: resultados del estudio internacional Vein Consult Program. Cir Esp. 2014;92 (8):539–546. https://medes.com/publication/92815
Pannier F, Rabe E. Differential diagnosis of leg ulcers. Phlebology 2012; 28(1):55-0. DOI:10.1177/0268355513477066
World Health Organization. Management of substance abuse [Internet].[Consultado 2014 May 12]. http://www.who.int/substance_abuse/research_tools/whoqolbref/en/
Rusbert Fernando Álvarez Del Río. Factores asociados a la Cicatrización de Úlceras Venosas de Miembros Inferiores y Calidad de Vida en Adultos, Medellín 2014-2015. Tesis. Facultad Nacional de Salud Pública Héctor Abad Gómez Medellín 2015. http://bibliotecadigital.udea.edu.co/handle/10495/3565
Secretaría de Salud. Guía de práctica clínica. Prevención, diagnóstico y tratamiento de la enfermedad venosa crónica. México: CENETEC; 2009
Espinóla CF, Bernau M, Aucejo M, et al. Prevalencia de várices en miembros inferiores en el personal del Hospital de Clínicas. Rev Chil Cir. 2007;59:342---7
Marques de Souza E, Bonetti Yoshida W, Aragao de Melo V, Bitencurt de Oliveir L. Ulcer Due to Chronic Venous Disease: A Sociodemographic Study in Northeastern Brazil Annals of Vascular Surgery. 2013;27:571-6. DOI: 10.1016/j.avsg.2012.07.021
Karanikolic V, Karanikolic A, Petrovic D, Stanojevic M. Prognostic factors related to delayed healing of venous leg ulcer treated with compression therapy. Dermatologica Sinica. 2015;33(4):206-9. DOI: 10.1016/j.dsi.2015.04.005
Moffatt CJ, Franks PJ, Doherty DC, Smithdale R, Martin R. Sociodemographic factors in chronic leg ulceration. Br J Dermatol 2006; 155(2):307-12. DOI: 10.1111/j.1365-2133.2006.07265.x
Gabriela Otero González*, Caroline Agorio Norstrom† , Miguel Martínez Asuaga. Úlceras de miembros inferiores Características clínico-epidemiológicas de los pacientes asistidos en la unidad de heridas crónicas del Hospital de Clínicas. Rev Méd Urug 2012; 28(3): 182-189. http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-03902012000300004
Labropoulos N, Wang E, Lanier S, Khan S. Factors Associated with Poor Healing and Recurrence of Venous Ulceration Plastic and Reconstructive Surgery 2012:179-86.
DOI: 10.1097/PRS.0b013e3182362a53
Haughey L, Barbul A. Nutrition and Lower Extremity Ulcers: Causality and/or Treatment. Int J Low Extrem Wounds. 2017 Dec;16(4):238-243. DOI: 10.1177/1534734617737639.
Juárez-Cedillo, T. Changes in nutritional needs with aging. In: Watson, RR ed. Nutritional and Functional Foods for Healthy Aging. San Diego, CA: Academic Press; 2017:27-41.
Langer, G, Fink, A. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2014;(6):CD003216. DOI: 10.1002/14651858.CD003216.pub2
I. Vázquez-Hernández ∗ y M. Acevedo-Pena. Prevalencia de enfermedad venosa periférica en el personal de enfermería. Enfermería Universitaria. 2016;13(3):166-170. DOI: 10.1016/j.reu.2016.05.003
Vuylsteke M, Thomis S, Guillaume G, Modliszewski M, Weides N, Staelens I. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. European Journal Of Vascular And Endovascular Surgery: The Official Journal Of The European Society For Vascular Surgery. 2015; 49(4):432-9. DOI: 10.1016/j.ejvs.2014.12.031
Vlajinac H, Marinkovic J, Maksimovic M, Radak D. Factors Related To Venous Ulceration: A Cross-Sectional Study. Angiology. 2014; 65(9):824-30. DOI: 10.1177/0003319713508218
Robertson L, Lee AJ, Gallagher K, Carmichael SJ, Evans CJ, McKinstry BH, et al. Risk factors for chronic ulceration in patients with varicose veins: A case control study. J Vasc Surg 2009; 49:1490-8. DOI: 10.1016/j.jvs.2009.02.237
Alguire P, Mathes B. Clinical manifestations of lower extremity chronic venous disease. Uptodate. 2014:1-15.
Ribu L, Birkeland K, Hanestadc B, Moumd T, Rustoen T. A longitudinal study of patients with diabetes and foot ulcers and theirhealth-related quality of life: wound healing and quality-of-life changes. Journal of Diabetes and Its Complications. 2008; 22:400-7. DOI: 10.1016/j.jdiacomp.2007.06.006
Kantor J, Margolis DJ. Management of leg ulcers. Semin Cutan Med Surg 2003; 22(3):212-21.
Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: a consensus statement (France, March 5-9, 1997). Circulation 2000; 102(20):E126-63.
Lozano F. Origen del síndrome de la clase turista: John Homans 2016;68(3):255-256. DOI: 10.1016/j.cger.2013.01.006
Thomas D. Managing Venous Stasis Disease and Ulcers. Clinical geriatric medicine. 2013;29:415-24. DOI: 10.1016/j.cger.2013.01.006
Carreño Ávila P. Terapéutica de la Compresión en el tratamiento de la úlcera de etiología venosa. Todoheridas. 2010;1(1):4-16. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2018000300153
Mauck K, Asi N, Elraiyah T, Undavalli C, Nabhan M, Altayar O, et al. Comparative systematic review and meta-analysis of compression modalities for the promotion of venous ulcer healing and reducing ulcer recurrence. J Vasc Surg. 2014;60(2, Supplement):71-90. 68. DOI: 10.1016/j.jvs.2014.04.060
Thomas F. O’Donnell Jr, MD, Marc A. Passman, MD, William A. Marston, MD, William J. Ennis, DO, Michael Dalsing, MD, Robert L. Kistner. Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery_ and the American Venous Forum. Journal vascular surgery. 2014; Volume 60, Number 2S: 3S-57S. DOI: 10.1016/j.jvs.2014.04.049
Brölmann FE, Ubbink DT, Nelson EA, Munte K, van der Horst CMAM, Vermeulen H. Evidence-based decisions for local and systemic wound care. Br J Surg 2012;99(9):1172- 83.
Dumville JC, Deshpande S, O'Meara S, Speak K. Hydrocolloid dressings for healing diabetic foot ulcers. The Cochrane database of systematic reviews. 2013;8:Cd009099.
DOI: 10.1002/bjs.8810
Palfreyman S, Nelson EA, Michaels JA. Dressings for venous leg ulcers: systematic review and meta-analysis. BMJ (Clinical research ed). 2007; 335(7613):244.). DOI: 10.1136/bmj.39248.634977.AE
Serra R, Grande R, Butrico L, et al. Effects of a new nutraceutical substance on clinical and molecular parameters in patients with chronic venous ulceration. Int Wound J 2016;13:88–96. DOI: 10.1111/iwj.12240
Raffetto JD. Pathophysiology of wound healing and alterations in venous leg ulcers- review. Phlebology 2016;31(1 Suppl):56–62. DOI: 10.1177/0268355516632998
Kurz X, Lamping D, Kahn S, Baccaglini U, Zuccarelli F, Spreafico G, et al. Do varicose veins affect quality of life? Results of an international population-based study. J Vasc Surg 2001; 34(4):641-8. DOI: 10.1067/mva.2001.117333