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静脉性腿部溃疡:已发表评估和治疗算法综述。

Venous Leg Ulcers: A Review of Published Assessment and Treatment Algorithms.

机构信息

3M Medical Solutions Division, 3M Company, St. Paul, Minnesota, USA.

Catholic Health Advanced Wound Healing Centers, Cheektowaga, New York, USA.

出版信息

Adv Wound Care (New Rochelle). 2022 Jan;11(1):28-41. doi: 10.1089/wound.2020.1381. Epub 2021 Apr 13.

Abstract

Chronic venous disease (CVD) is prevalent in the aging population and leads to venous leg ulcers (VLUs). These wounds can last and recur for years, significantly impacting quality of life. A large body of literature exists on CVD and VLU diagnosis and treatment. Multiple algorithms, guidelines, and consensus documents have been published on this topic, highlighting the importance of this issue in clinical practice. However, these documents are not fully aligned with each other. The latest update of the internationally used classification system for CVD was recently published. Our review aims to summarize the existing information to provide an educational tool for clinicians new to this topic, and to highlight the commonalities between the published recommendations. VLUs need to be treated with consideration for the extent of venous disease present in the patient. This requires a good understanding of the various components involved and the possible additional concomitant conditions by the first-line clinician who encounters the patient. A multidisciplinary team is necessary for a successful overall treatment plan, and this plan should be tailored to each patient's specific needs and lifestyle. Compression is still the mainstay of treatment for CVD and VLUs. Compression is needed long term, but it does not suffice by itself to prevent recurrences without interventional correction. Venous intervention should be offered early to prevent or slow disease progression and reduce recurrence.

摘要

慢性静脉疾病(CVD)在老年人群中较为普遍,并导致静脉性腿部溃疡(VLU)。这些伤口可能持续多年并反复发作,显著影响生活质量。大量文献涉及 CVD 和 VLU 的诊断和治疗。针对这一主题,已经发布了多个算法、指南和共识文件,强调了这一问题在临床实践中的重要性。然而,这些文件之间并非完全一致。最近发布了国际上使用的 CVD 分类系统的最新更新。我们的综述旨在总结现有信息,为接触这一主题的临床医生提供教育工具,并强调已发布建议之间的共同之处。 VLU 需要根据患者静脉疾病的严重程度进行治疗。这需要一线临床医生对所涉及的各个方面以及可能存在的其他伴随情况有很好的了解。需要多学科团队来制定成功的整体治疗计划,并且该计划应根据每位患者的具体需求和生活方式进行定制。 对于 CVD 和 VLU,加压治疗仍然是主要治疗方法。需要长期进行加压治疗,但如果没有介入矫正,仅靠加压治疗本身不足以预防复发。应尽早进行静脉介入治疗,以预防或减缓疾病进展并减少复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80de/8573799/fd7ef68d6e7a/wound.2020.1381_figure4.jpg

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