Trophische Geschwür an den Füßen - Behandlung Behandlung von venösen Beingeschwüren Cues

By continuing to browse this site you agree to us using cookies as described in About Cookies Georgina Gethin, School of Nursing and Midwifery, National University of Ireland, Aras Moyola, National University of Ireland Galway, Galway, 0, Ireland. Best practice documents and expert opinion suggests that the removal of devitalised tissue from venous ulcers debridement by any one of six methods helps to promote healing.

However, to date there has been no review of the evidence from randomised controlled trials RCTs to support this.

To determine the effects of different debriding methods or debridement versus no debridement, on the rate of debridement and wound healing in venous leg ulcers. There were no restrictions with respect to language, date of publication or study setting.

In addition we handsearched conference proceedings, journals not cited in MEDLINE, and Krampfadern Salbe von Krampfadern information bibliographies of all retrieved publications to identify potential studies.

We made contact with the pharmaceutical industry to enquire about any completed studies. We included RCTs, either published or unpublished, which compared two methods of debridement or compared debridement with no debridement.

We presented study results in a narrative form, as meta-analysis was not possible. Independently, two review authors completed all study selection, data extraction and assessment of trial quality; resolution of disagreements was completed by a third review author. We identified 10 RCTs involving participants. Eight RCTs evaluated autolytic debridement and included the following agents learn more here dressings: biocellulose wound dressing BWDnon-adherent dressing, honey gel, hydrogel gel formulahydrofibre dressing, hydrocolloid dressings, dextranomer beads, Edinburgh University Solution of Lime EUSOL and paraffin gauze.

Two RCTs evaluated enzymatic preparations and one evaluated biosurgical debridement. No RCTs evaluated surgical, sharp or mechanical methods of debridement, or debridement visit web page no debridement.

Most trials were at a high risk of bias. Three RCTs assessed the number of wounds completely debrided. Four trials assessed the mean time to achieve debridement: one 86 participants compared two autolytic debridement methods, two compared autolytic methods with enzymatic debridement 71 participantsand the last 12 participants compared autolytic with biosurgical debridement; none of the results achieved statistical significance.

Two trials that assessed autolytic debridement methods reported the number of wounds healed at 12 weeks. Reduction in wound size was assessed in five trials participants in which two autolytic methods were compared. Results were statistically significant in one three-armed trial participants when cadexomer iodine was click here to paraffin gauze mean difference Pain was assessed in six trials participants that compared two autolytic debridement methods, but the results were not statistically significant.

No serious adverse events were reported in any trial. There is limited evidence to suggest that actively debriding a venous leg ulcer has a clinically significant impact on healing. The overall small number of participants, low number of studies and lack of meta-analysis in this review precludes any Behandlung von venösen Beingeschwüren Cues conclusions of benefit. Comparisons of different autolytic agents hydrogel versus paraffin gauze; Dextranomer beads versus EUSOL and BWD versus non-adherent dressings and Larvae versus hydrogel all showed statistically significant results for numbers of wounds debrided.

Larger trials with follow up to healing are required. Venous leg ulcers are a common type of leg wound. They can cause pain, stress, social Behandlung von venösen Beingeschwüren Cues and depression. These ulcers take approximately 12 weeks to heal Behandlung von venösen Beingeschwüren Cues the best and first treatment to try is compression bandages.

In an attempt to improve the healing process it is thought that removing dead or dying tissue debridement from the surface of the wound can speed up healing.

Six different methods can be used to achieve debridement: use of an instrument such as a scalpel with or without anaesthesia - Behandlung von venösen Beingeschwüren Cues debridement and sharp debridement, respectively ; washing solutions and dressings mechanical debridement ; enzymes that break down the affected tissue enzymatic debridement ; moist dressings or natural agents, or both, to promote the Behandlung von venösen Beingeschwüren Cues own healing processes autolytic debridement ; or maggots biosurgical debridement.

We assessed evidence from medical research to try to determine how effective these different methods of debridement are in debriding wounds. We also wanted to understand what effect, if any, debridement has on the healing of venous ulcers, and whether learn more here method of debridement is better than no debridement when it comes to wound healing.

We searched a wide range of electronic databases and also reports from conferences up to 10 February We included studies written Blutungen mit Krampfadern der unteren Extremität any language that included men Behandlung von venösen Beingeschwüren Cues women of any age, cared for in any setting, from any country, and we did not set a limit on the years in which studies were published.

We were only interested in robust research, and so restricted our search to randomised controlled trials in which people are randomly allocated to the methods being tested. All trial participants were required to have a venous ulcer with dead tissue slough present in the wound.

We found ten studies that included a total of Behandlung von venösen Beingeschwüren Cues. These were conducted in a range of countries and care settings.

Participants had an average age of 68 years, and there were more women than men. Most of the studies were small, with half of them having fewer than 67 participants. The trials tested Behandlung von venösen Beingeschwüren Cues range of debridement methods including: autolytic methods such as non-adherent dressings; very small beads; biocellulose dressings; honey; gels; gauze and Endometriumablation Homöopathie Behandlung von trophischen Geschwüren Tage using enzymes.

Autolytic methods of debridement, were http://varizonhealth.de/orbitrek-varizen.php most frequently tested. We identified no studies that tested surgical, sharp or mechanical methods of debridement and no studies that tested debridement against no debridement. It was not possible to say whether any of the methods evaluated performed better than the rest.

What remains uncertain at this time is whether debridement itself, or any particular form of debridement is beneficial in the treatment of venous ulcers.

The overall quality of the evidence we identified was low, as studies were small in size, Behandlung von venösen Beingeschwüren Cues most were of short duration. There were differences between them in terms of the amount click here slough in the wound bed of the ulcers at the start of the trial, in treatment regimes, the duration of treatments, and the methods used Behandlung von venösen Beingeschwüren Cues assess how well the debridement treatments had Behandlung von venösen Beingeschwüren Cues. In six trials, the people assessing the wounds were aware of the type of treatment each patient was receiving, which may have affected the impartiality of their evaluations.

Five studies did not provide information on all the results outcomes in their trials, and this missing information on important benefits or harms of the debridement method being evaluated meant that those trials were at a high risk of bias and of producing unreliable results.

Only two studies reported side effects due to the treatment; these included maceration or wetness of the skin around the ulcers, infection and skin inflammation. Diese können Schmerzen, Stress, soziale Isolation und Depressionen verursachen. Die Geschwüre brauchen rund 12 Wochen, um zu heilen.

Behandlung von venösen Beingeschwüren Cues beste und bevorzugte Behandlung sind Kompressionsbinden. Wir haben eine breite Behandlung von venösen Beingeschwüren Cues von elektronischen Datenbanken und Konferenzberichten bis zum Dabei berücksichtigten wir Studien aller Sprachen mit Männern und Behandlung von venösen Beingeschwüren Cues aller Alterssparten, aus allen Ländern und allen möglichen Behandlungszusammenhängen.

Auch beim Publikationsjahr machten wir keine Einschränkungen. Wir interessierten uns nur für robuste Forschung und beschränkten die Suche deshalb auf randomisierte, kontrollierte Studien in denen Patienten zufällig auf die getesteten Methoden verteilt werden. Alle Studienteilnehmer mussten ein venöses Beingeschwür mit Behandlung von venösen Beingeschwüren Cues Gewebe in der Wunde aufweisen.

Wir fanden zehn Studien mit insgesamt Teilnehmern. Diese wurden in verschiedenen Ländern und Behandlungssettings durchgeführt. Die Teilnehmer mehr Frauen als Männer waren im Durchschnitt 68 Jahre alt. Die meisten dieser Studien waren Behandlung von venösen Beingeschwüren Cues die Hälfte hatte weniger als 67 Teilnehmer. Es war nicht möglich festzustellen, ob irgendeine der Methoden bessere Ergebnisse erzielt als die anderen.

Es gab eine gewisse Evidenz dafür, dass schmierige Geschwüre, aus denen nach vier Wochen mehr als 50 Prozent des toten Gewebes entfernt worden war, click the following article grösserer Wahrscheinlichkeit nach zwölf Wochen verheilt waren. Die Gesamtqualität der von uns gefundenen Evidenz war gering, da die Studien klein waren und meistens nur über eine kurze Zeitdauer liefen.

In sechs Studien wussten Behandlung von venösen Beingeschwüren Cues Personen, die die Wunden später untersuchten, welche Art Behandlung die Patienten erhalten hatten.

Dadurch waren sie visit web page ihrer Bewertung eventuell nicht unvoreingenommen. Fünf Studien lieferten keine komplette Information zu allen Resultaten Endpunkten. Nur zwei Studien berichteten von Nebenwirkungen der Behandlung, darunter Aufquellen oder Nässen der Haut um die Geschwüre herum, Infekte und Hautentzündungen.

Request Permissions Article first published online: 14 Sep DOI: All Rights Reserved By continuing to browse this site you agree to us using cookies as described in About Cookies Remove maintenance message Cochrane. Search for more papers by this author Royal College of Surgeons in Ireland Bahrain, Manama, Bahrain Search for more papers by this author Landgraaf, Netherlands Search for more papers by this author First published: 14 September Editorial Group: Cochrane Wounds Group DOI: Objectives To determine the effects of different debriding methods or debridement versus no debridement, on the rate of debridement and wound healing in venous leg ulcers.

Selection criteria We included RCTs, either click to see more or unpublished, which compared two methods of debridement or compared debridement with no debridement.

Data collection and analysis Independently, two review authors completed all study selection, data extraction and assessment of trial quality; resolution of disagreements was completed by a third review author. Main results We identified 10 RCTs involving participants. Authors' conclusions There more info limited evidence to suggest that actively debriding a venous leg ulcer has a clinically significant impact on healing.

English Croatian German Plain language summary Debridement for venous leg ulcers Background Venous Behandlung von venösen Beingeschwüren Cues ulcers are a common type mit Krampfadern Lebensstil leg wound.

Objectives We assessed evidence from medical research to try to determine how effective these different methods Behandlung von venösen Beingeschwüren Cues debridement are in debriding wounds. Search methods We searched a wide range of electronic databases and also reports from conferences up to 10 February Results We found ten studies that included a total of participants.

Suchmethoden Wir haben eine breite Palette von elektronischen Datenbanken und Konferenzberichten bis zum Ergebnisse Wir fanden zehn Studien mit insgesamt Teilnehmern. Anmerkungen zur Übersetzung R. Fischer, freigegeben durch Cochrane Schweiz. Continue reading full article DOI CD Number of times cited : 1 1 Judith GüntherUwe FrickeArzneiverordnungs-Report, CrossRef PDF Info Close article support pane Cochrane Cochrane About Cochrane Cochrane.


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Versorgung chronischer Wunden

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