DOI: 10.35279/jowm202110.03 SCIENCE, PRACTICE AND EDUCATION Deep vein insufficiency and the results of four-layer compression bandages in the treatment of venous ulcers: A retrospective study Dr Alberto Garavello, Vascular Surgery Specialist, Emergency Department, Center for Therapy of Lower Limbs Ulcers, San Filippo Neri Hospital, Rome, Italy Dr Pietro Franzvea , General Surgery Specialist, Policlinico Agostino Gemelli Hospital, Rome, Italy Dr Massimo Tozzi , Researcher in Statistical Sciences, Rome, Italy Stefania Gilardi, Paola Fiamma, Nurses Wound Care Specialists, Center for Therapy of Lower Limbs Ulcers, San Filippo Neri Hospital, Rome, Italy Correspondence: garavellalberto@gmail.com · Conflicts of interest: None Keywords: Chronic venous insufficiency, four-layer bandage, venous ulcers ABSTRACT Background Venous ulcers of the lower limbs affect 1 to 3% of the Western population; at present, elastic compression is the first line of therapy. Some authors have found that insufficient deep venous circulation may delay ulcer healing during compression therapy. Hypothesis/aim In a group of patients with venous ulcers, we verified whether or not deep venous insufficiency (DVI) as- sociated with superficial venous insufficiency (SVI) may worsen the outcomes of four-layer elastic com- pression bandage (4LB). tients (20.9%). In patients with SVI alone, the mean healing time was 81 ± 91 days, and in patients with DVI associated with SVI, it was 108 ± 123 days; the difference between the two groups was not statistically significant (p> 0.2). Ulcer healing was achieved in 90 patients— 41 with SVI alone, 21 with SVI combined with DVI; the difference was not statistically significant. Conclusions Using 4LB allows ulcer healing with no difference in outcome between patients with SVI alone and those with SVI associated with DVI. Methods A total of 124 patients participated in the study. Ecocolordopper results of superficial and deep ve- nous circulation examinations and the patient’s data, including age, sex and clinical history, were collected in an Excel database. A 4LB was applied, and patients were checked twice per week at our clinic, where therapeutic outcomes were recorded. Results/Findings In 62 patients, we found only SVI (66.9%), DVI in 42 patients (33.9%, 38 popliteal veins, 17 femoral veins) and both SVI and DVI conditions in 26 pa- Implication for clinical practice A 4LB is effective in varicose ulcer therapy; the car- egivers’ skills are critical, and home assistance for elderly patients is needed because too many live far from the hospital and cannot follow the therapy protocols on their own. Abbreviations DVI –Deep venous insufficiency SVI – Superficial vein insufficiency 4LB –Four-layer bandage JOURNAL OF WOUND MANAGEMENT OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATION 15
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