ascorbic-acid and Varicose-Ulcer

It has been reported that carbohydrates confer physicochemical properties to the wound environment that improves tissue repair. We evaluated in vitro and in vivo wound healing during maltodextrin/ascorbic acid treatment. In a fibroblast monolayer scratch assay, we demonstrated that maltodextrin/ascorbic acid stimulated monolayer repair by increasing collagen turnover coordinately with TGF-β1 expression (rising TGF-β1 and MMP-1 expression, as well as gelatinase activity, while TIMP-1 was diminished), similar to in vivo trends. On the other hand, we observed that venous leg ulcers treated with maltodextrin/ascorbic acid diminished microorganism population and improved wound repair during a 12 week period. When maltodextrin/ascorbic acid treatment was compared with zinc oxide, almost four fold wound closure was evidenced. Tissue architecture and granulation were improved after the carbohydrate treatment also, since patients that received maltodextrin/ascorbic acid showed lower type I collagen fiber levels and increased extracellular alkaline phosphatase activity and blood vessels than those treated with zinc oxide. We hypothesize that maltodextrin/ascorbic acid treatment stimulated tissue repair of chronic wounds by changing the stage of inflammation and modifying collagen turnover directly through fibroblast response.

Topics: Administration, Cutaneous; Adult; Aged; Aged, 80 and over; Antioxidants; Ascorbic Acid; Case-Control Studies; Collagen Type III; Drug Combinations; Female; Humans; Longitudinal Studies; Lower Extremity; Male; Middle Aged; Pilot Projects; Polysaccharides; Prospective Studies; Random Allocation; Tissue Inhibitor of Metalloproteinase-1; Transforming Growth Factor beta1; Varicose Ulcer; Wound Healing; Zinc Oxide

To assess patients' satisfaction from the therapy of advanced chronic venous disorders (CVD) in everyday clinical practice in Poland, and to compare the efficacy of various venoactive drugs (VADs) in venous ulcers healing process.. Seven hundred and eighty unselected adult patients with active (N.=441) or healed (N.=339) venous ulcers participated in the non-interventional observational 6-week study.. Compression therapy and VADs were utilized by 81.5% and 89.2% of patients respectively: 31.2% of all patients underwent surgical procedures for vein incompetence, 61.3% were satisfied with surgical methods, 43% with compression therapy, and 32.6% with VADs ‑ with highest rate of satisfied patients in the group taking Ruscus aculeatus and HMC and ascorbic acid (51.4%). Of 377 patients with active venous ulcers smaller than 200 cm2, adherent to VADs, 18.0% have been cured, and 66.6% have improved during 6-week period of observation. Multiple logistic regression analysis revealed that the compression therapy (OR=2.74), the size of ulcer ≤10 cm2 (OR=2.70) were increasing the change of ulcer healing. No VADs was better than another in the healing process.. 1) Compression therapy and VADs are highly utilized by patients with advanced CVD. 2) Patients are more satisfied with surgical than conservative treatment of advanced CVD. 3) More than half of the patients with the advanced stage CVD taking Ruscus aculeatus and HMC and ascorbic acid is satisfied with the obtained improvement. 4) Ruscus aculeatus and HMC and ascorbic acid is similarly effective as other frequently used VADs in venous ulcer healing. 5) Ruscus aculeatus and HMC and ascorbic acid exerting effects on veins, capillaries and lymphatic vessels may explain the positive results observed in this study.

Topics: Aged; Ascorbic Acid; Chalcones; Chronic Disease; Female; Hesperidin; Humans; Male; Middle Aged; Patient Satisfaction; Phytotherapy; Plant Extracts; Ruscus; Severity of Illness Index; Varicose Ulcer; Wound Healing

Obesity is a chronic disease that is linked to the presence of numerous chronic illnesses, including venous disease. Venous disease can lead to chronic wounds, which may be exacerbated by vitamin, mineral, and macro-nutritional deficiencies. A cross-sectional observational design was used to examine the nutritional status of patients with chronic venous leg ulcers (VLUs) who are overweight or obese and to explore the relationship between nutritional status and severity of venous ulceration. Nutritional status was evaluated using anthropometric measurements, nutrient analysis from a 3-day dietary intake log, serum albumin, vitamins A and C, and zinc levels. Wound severity was assessed using the Leg Ulcer Measurement Tool (LUMT). Eight patients participated; six patients were men, and all eight patients were more than 50 years of age. Patients had an average daily caloric intake below their estimated caloric need. When compared with recommended daily intake levels, dietary nutrient intake was suboptimal for protein, vitamin C, and zinc. Serum levels were below normal for at least one of these nutrients in six patients. A positive correlation was found only between serum albumin, average daily intake, and percent recommended daily intake of protein (r(s) = 0.93, P = .003). An inverse relationship was found between LUMT score and serum vitamin A levels (r(s) = -0.83, P = .01), and a positive correlation was observed between LUMT score and serum vitamin C (r(s) = 0.74, P = .04). No clear relationships were shown among serum zinc, albumin, and LUMT scores. Overweight and obese patients with VLU show nutritional deficits that are similar to those of the broader population of patients with leg ulcers. The relationships found between vitamins A and C and leg ulcer severity warrant further exploration. The nutritional differences in the study need to be examined in a larger sample of overweight and normal-weight patients to determine whether overweight patients are at greater risk for prolonged VLU because of poor nutrition than non-overweight patients.

Topics: Aged; Anthropometry; Ascorbic Acid; Body Mass Index; Cross-Sectional Studies; Deficiency Diseases; Energy Intake; Female; Humans; Male; Middle Aged; Northwestern United States; Nutrition Assessment; Nutrition Policy; Nutrition Surveys; Nutritional Status; Obesity; Pilot Projects; Serum Albumin; Severity of Illness Index; Varicose Ulcer; Vitamin A; Zinc

Since oedema of adjacent tissue is a major factor in preventing healing of leg ulcers conservative treatment should aim to dry out the ulcer area before bandaging and to keep it dry afterwards. A method of postural drainage of oedema is described in which the patient lies supine with the legs raised vertically for two days. Non-stretch Viscopaste bandages are then applied and the patient allowed to move about normally, but instructed to continue vertical leg drainage for a period each day. Out of 106 cases treated by this method the leg ulcer healed within a year in 82 (77.4%). Relapses were apt to occur when the patient neglected to continue the vertical drainage regimen after the ulcer had healed. These results compare well with those reported for other methods of treatment. Vertical leg drainage treatment is inexpensive and the patient can continue at work.

Topics: Adult; Ascorbic Acid; Bandages; Edema; Female; Humans; Leg Ulcer; Male; Posture; Varicose Ulcer; Wound Healing

Topics: Adult; Aged; Ascorbic Acid; Caproates; Citrates; Female; Flavonoids; Frostbite; Humans; Male; Middle Aged; Nucleosides; Phlebitis; Rutin; Skin Diseases; Telangiectasis; Varicose Ulcer; Varicose Veins; Vascular Diseases