Rapid healing of venous ulcers with terminal, axial and perforator interruption of the reflux source (TAPIRS) plus multilayer bandage: A clinical trial

Introduction Chronic venous ulcers (CVU) are the most common ulcers occurring in the lower limbs, having a high morbidity and place a high financial strain on the health system. The traditional surgical techniques are being replaced by minimally invasive procedures, such as foam sclerotherapy. Objec...

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Autores:
Tipo de recurso:
Fecha de publicación:
2016
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/22234
Acceso en línea:
https://doi.org/10.1016/j.angio.2016.02.008
https://repository.urosario.edu.co/handle/10336/22234
Palabra clave:
Polidocanol
Adult
Ankle brachial index
Article
Bandage
Clinical article
Clinical protocol
Disease duration
Follow up
Human
Middle aged
Prospective study
Surgical technique
Terminal axial and perforator interruption of the reflux source
Ulcer healing
Vein insufficiency
Vein occlusion
Foam
Sclerotherapy
Venous ulcer
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Abierto (Texto Completo)
Description
Summary:Introduction Chronic venous ulcers (CVU) are the most common ulcers occurring in the lower limbs, having a high morbidity and place a high financial strain on the health system. The traditional surgical techniques are being replaced by minimally invasive procedures, such as foam sclerotherapy. Objective The aim of this study was to determine CVU healing times and rates using the terminal, axial and perforator interruption of the reflux source (TAPIRS) protocol, which included an endoluminal venous occlusion with ultrasound-guided foam and a multilayer bandage system until achieving ulcer healing. Material and methods A prospective uncontrolled trial was conducted on patients with chronic venous leg ulcers (CEAP [clinical, etiological, anatomical and pathological elements] C6) during 2013 and 2014. A total of 17 patients aged 18 years and over, presenting with venous insufficiency, CVU, and an ankle-brachial index greater than 0.8, were included, and total of 17 limbs were analysed. All of the patients were subjected to endoluminal occlusion with ultrasound-guided foam in the axial superficial venous system and perforator and terminal veins near to the ulcer, using Tessari method with 3% polidocanol. Follow-up was carried out at every week and a doppler test was conducted after 4 and 12 weeks. Results The mean age of the patients was 56.4 years. The active ulcer duration prior to treatment was 2.96 years. The study showed that all CVU were healing before 7 weeks, the healing rate was 3.92 cm2/week, and the time until the ulcer was healed was 3.53 weeks (24 days). Conclusions The minimally invasive ablation of terminal, axial and perforator reflux with compression in patients is a technique that leads to faster healing times of CVU. © 2016 SEACV