Kosuyolu Heart J 2013;16(1)
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Kosuyolu Heart J 2013;16(1):54-57 - doi: 10.5578/kkd.4165
Kronik Venöz Yetmezliğe Bağlı Venöz Bacak lserlerinde Çok Katlı Kompresyon Bandaj Sistemlerinin Etkisi

Effect of Multi-layer Compression Bandage Systems on Leg Ulcers
Associated with Chronic Venous Insufficiency

Hüseyin Kuplay1, Berk Özkaynak1, Bülent Mert1, Sevinç Bayer Erdoğan2, Serkan Sönmez1,
Nihan Kayalar1, Mustafa Bora Farsak3, Vedat Erentuğ4


1 Department of Cardiovascular Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey

2 Department of Cardiovascular Surgery, Bitlis State Hospital, Bitlis, Turkey

3 Department of Cardiovascular Surgery, Faculty of Selcuklu Medicine, Selcuk University, Konya, Turkey

4 Department of Cardiovascular Surgery, Faculty of Medicine, Erzincan University, Erzincan, Turkey

ABSTRACT

Introduction: Venous leg ulcer is a major health problem in terms of high prevalence and high cost for treatment. Multi-layer compression bandage systems for venous leg ulcers are supposed to be the gold standard for the treatment of venous ulcers. The aim of the current study is to investigate the effectiveness of multi-layer compression bandage systems for the treatment of venous leg ulcers.

Patients and Methods: Nineteen consecutive patients diagnosed to have leg ulcers were evaluated and four patients were excluded from the study due to the peripheral arterial disease. Fifteen patients, enrolled in the study, were classified according to CEAP classification and belonged to the same class. Betaven® multi-layer compression bandage was applied to patients. Patients were followed-up in terms of wound healing and reduction in wound diameter.

Results: Twelve male and three female patients underwent multi-layer bandage system. Mean age of patients was 38.2 ± 4.2 years. Ulcer size was measured planimetrically and baseline ulcer size was 4-10 cm². The location of ulcer was on medial malloelus in seven patients, lateral malleolus in three patients, anterior surface of the leg in four patients and lateral side of the leg in one patient. Patients had chronic venous insuuficiency for a mean of 5.1 ± 2.1 years. CEAP classifications were C6, Ep, As2,3-p18, Pr2,3, 18. Each bandage was changed five days after application along with wound care. Mean duration of treatment was 6 ± 2 weeks. Complete healing of the venous ulcers occurred in all patients except for one. This patient was referred to plastic surgery clinic for reconstruction.

Conclusion: Multi-layer compression bandage system is an effective method of treatment for venous leg ulcers associated with chronic venous insufficiency by reducing venous return and increasing intertitial tissue pressure. This effect occurred in the shortrun as well as with a low cost and prevented loss of labor.

Key Words: Leg ulcer; compression bandages; venous insufficiency.

Received: 23.08.2012 Accepted: 27.08.2012

Correspondence

Dr. Hüseyin Kuplay

İstanbul Bağcılar Eğitim ve Araştırma Hastanesi,

Kalp ve Damar Cerrahisi Kliniği

İstanbul-Türkiye

e-posta: hkuplay@hotmail.com

Kronik Venöz Yetmezliğe Bağlı Venöz Bacak lserlerinde Çok Katlı Kompresyon Bandaj Sistemlerinin Etkisi

Kronik Venöz Yetmezliğe Bağlı Venöz Bacak Ülserlerinde
Çok Katlı Kompresyon Bandaj Sistemlerinin Etkisi

Effect of Multi-layer Compression Bandage Systems on Leg Ulcers
Associated with Chronic Venous Insufficiency

Hüseyin Kuplay1, Berk Özkaynak1, Bülent Mert1, Sevinç Bayer Erdoğan2, Serkan Sönmez1,
Nihan Kayalar1, Mustafa Bora Farsak3, Vedat Erentuğ4


1 İstanbul Bağcılar Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye

1 Department of Cardiovascular Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey

2 Bitlis Devlet Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bitlis, Türkiye

2 Department of Cardiovascular Surgery, Bitlis State Hospital, Bitlis, Turkey

3 Selçuk Üniversitesi Selçuklu Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Konya, Türkiye

3 Department of Cardiovascular Surgery, Faculty of Selcuklu Medicine, Selcuk University, Konya, Turkey

4 Erzincan Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Erzincan, Türkiye

4 Department of Cardiovascular Surgery, Faculty of Medicine, Erzincan University, Erzincan, Turkey

ÖZET

Giriş: Kronik venöz yetmezliğe bağlı bacak ülserleri yüksek prevalans ve tedavi için yüksek maliyet açısından çok önemli bir sağlık problemidir. Venöz bacak ülserlerinin tedavisinde çok katlı kompresyon bandaj sistemleri altın standarttır. Çalışmamızın amacı çok katlı kompresyon bandaj sistemin kronik venöz yetmezliğe bağlı oluşan venöz bacak ülserlerinin tedavisinde etkinliğini araştırmaktır.

Hastalar ve Yöntem: Kliniğimize başvuran bacak ülserli ardışık 19 hasta değerlendirildi ve dört hasta periferik arter hastalığı nedeniyle çalışmadan çıkarıldı. Toplam 15 hasta çalışmaya dahil edildi. Hastaların CEAP sınıflandırmaları yapıldı ve tüm hastalar aynı CEAP sınıfına dahildi. Hastalara Betaven® çok katlı kompresyon bandajı uygulandı. Hastalar yara iyileşmeleri açısından takip edildi. Hastaların ülser boyutları planimetrik olarak ölçülerek değerlendirildi. Takip kriteri olarak yara iyileşmesi, yara alanında azalma esas alındı.

Bulgular: Kliniğimizde toplam 12 erkek ve üç kadın hastaya çok katlı bandaj sistemi uygulandı.Hastaların yaş ortalaması 38.2 ± 4.2 idi. Hastaların ülser boyutları planimetrik olarak ölçüldü.Ülser boyutlar 4-10 cm² idi. Hastaların ülserleri yedi hastada medial malleol ayak bileği seviyesinde, üç tanesi lateral malleol düzeyinde, dört tanesi bacak ön yüzde bir tanesi bacak lateral yüzeydeydi. Hastalarda ortalama 5.1 ± 2.1 yıldır kronik venöz yetmezlik bulunmaktaydı. Hastaların CEAP sınıflaması C6, Ep, As2,3-p18, Pr2,3, 18 şeklindeydi. Ortalama tedavi süresi 6 ± 2 hafta olarak gerçekleşti ve bir hasta dışında tüm hastalarda tam iyileşme sağlandı. Bu hasta da rekonstrüksiyon amacıyla plastik cerrahi kliniğine yönlendirildi.

Sonuç: Çok katlı kompresyon bandaj sistemleri intersisyel doku basıncını artırarak venöz dönüşü artırır ve venöz hipertansiyonu azaltarak kronik venöz yetmezliğe bağlı oluşan venöz bacak ülserlerinin tedavisinde etkili olur. Bu etkisi kısa sürede ortaya çıkmakta hem düşük maliyetle tedavi edilmekte hem de işgücü kaybının önüne geçilmektedir.

Anahtar Kelimeler: Bacak ülseri, sıkıştırma bandajlar, venöz yetmezlik.

Geliş Tarihi: 23.08.2012 Kabul Tarihi: 27.08.2012

ABSTRACT

Introduction: Venous leg ulcer is a major health problem in terms of high prevalence and high cost for treatment. Multi-layer compression bandage systems for venous leg ulcers are supposed to be the gold standard for the treatment of venous ulcers. The aim of the current study is to investigate the effectiveness of multi-layer compression bandage systems for the treatment of venous leg ulcers.

Patients and Methods: Nineteen consecutive patients diagnosed to have leg ulcers were evaluated and four patients were excluded from the study due to the peripheral arterial disease. Fifteen patients, enrolled in the study, were classified according to CEAP classification and belonged to the same class. Betaven® multi-layer compression bandage was applied to patients. Patients were followed-up in terms of wound healing and reduction in wound diameter.

Results: Twelve male and three female patients underwent multi-layer bandage system. Mean age of patients was 38.2 ± 4.2 years. Ulcer size was measured planimetrically and baseline ulcer size was 4-10 cm². The location of ulcer was on medial malloelus in seven patients, lateral malleolus in three patients, anterior surface of the leg in four patients and lateral side of the leg in one patient. Patients had chronic venous insuuficiency for a mean of 5.1 ± 2.1 years. CEAP classifications were C6, Ep, As2,3-p18, Pr2,3, 18. Each bandage was changed five days after application along with wound care. Mean duration of treatment was 6 ± 2 weeks. Complete healing of the venous ulcers occurred in all patients except for one. This patient was referred to plastic surgery clinic for reconstruction.

Conclusion: Multi-layer compression bandage system is an effective method of treatment for venous leg ulcers associated with chronic venous insufficiency by reducing venous return and increasing intertitial tissue pressure. This effect occurred in the shortrun as well as with a low cost and prevented loss of labor.

Key Words: Leg ulcer; compression bandages; venous insufficiency.

Received: 23.08.2012 Accepted: 27.08.2012

Yazışma Adresi/Correspondence

Dr. Hüseyin Kuplay

İstanbul Bağcılar Eğitim ve Araştırma Hastanesi,

Kalp ve Damar Cerrahisi Kliniği

İstanbul-Türkiye

e-posta: hkuplay@hotmail.com

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