rutin and Varicose-Ulcer

Venous leg ulcers are a major health burden: annually, in the UK alone, they contribute an estimated cost to the NHS of GBP 400 million. Flavonoids are a diverse group of naturally-occurring venotonic compounds that address certain microcirculatory parameters involved in venous leg ulcer pathophysiology.. To evaluate the clinical effects of flavonoids on the healing of venous leg ulcers.. In February 2013 we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 1); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. No date or language restrictions were applied. We checked reference lists of included trials, and contacted pharmaceutical companies.. Randomised controlled trials (RCTs) that investigated the efficacy of any flavonoid-containing compound on venous leg ulcer healing in adults.. Two review authors independently assessed trials for the review and disagreements were referred to a third author. All rejected articles were double-checked by a third author. Assessment of risk of bias and data extraction were performed independently by two authors, discrepancies were resolved by referring to the third author.. Of the nine studies (1075 participants): five investigated Micronised Purified Flavonoid Fraction (MPFF), and four investigated hydroxyethylrutosides (HR).Meta-analysis involving 723 participants from five trials - four of which were characterised by poor reporting - showed more venous leg ulcers were healed in the MPFF groups than in the control groups (RR 1.36; 95% CI 1.07 to 1.74). However, the most rigorously conducted trial, which was at low risk of bias, did not show any additional benefit of MPFF (RR 0.94; 95% CI 0.73 to 1.22). Since this trial was unpublished, the possibility of publication bias in trials involving flavonoids must be acknowledged. Overall, the quality of reporting of trials on HR was also poor. Pooling three trials, all at unclear risk of bias, involving 279 participants showed a statistically significant effect in favour of HR with respect to number of ulcers healed (RR 1.70; 95% CI 1.24 to 2.34).. Although the overall estimate of the number of healed ulcers appeared to show a significant effect in favour of flavonoids (both MPFF and HR), this result needs to be interpreted cautiously, as most of these trials were poorly reported, and so had an unclear risk of bias for randomisation, allocation concealment, blinding and methods for addressing incomplete outcome data. There was also a possibility of publication bias.

Topics: Adult; Flavonoids; Humans; Hydroxyethylrutoside; Randomized Controlled Trials as Topic; Varicose Ulcer

This literature survey of the medical treatment of venous ulcers of the lower extremities discusses five classes of agents: (1) fibrinolytics, (2) hydroxyrutosides, (3) prostaglandins, (4) methylxanthines, and (5) others. The authors conclude that all these agents require further research.

Topics: Alprostadil; Diosmin; Humans; Hydroxyethylrutoside; Pentoxifylline; Stanozolol; Varicose Ulcer

The value of oxerutins [O-(beta-hydroxyethyl)-rutosides] in the prevention of venous ulcer recurrence was investigated in a double-blind randomized controlled trial of 138 patients with recently healed chronic venous ulcers. Oxerutins in the form of Paroven 500 mg twice daily or identical placebo were given, and all patients were provided with elastic compression stockings. At follow-up 3 months later, patients were assessed for re-ulceration and for tablet and stocking compliance. Oxerutins (n = 69) and placebo (n = 69) groups were well matched for age, sex, duration of previous ulceration and deep vein thrombosis. Cumulative re-ulceration by life-table analysis at 12 and 18 months was 22 and 32 per cent respectively for placebo, and 23 and 34 per cent respectively for oxerutins (P = 0.93). Recurrence was more frequent in patients who complied with both tablets and stockings, suggesting that compliance was influenced by continued symptoms (P = 0.006). This trial failed to demonstrate that oxerutins influenced ulcer recurrence.

Topics: Anticoagulants; Bandages; Double-Blind Method; Humans; Hydroxyethylrutoside; Patient Compliance; Recurrence; Varicose Ulcer

Topics: Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Eczema; Edema; Humans; Hydroxyethylrutoside; Placebos; Restless Legs Syndrome; Rutin; Surveys and Questionnaires; Varicose Ulcer; Venous Insufficiency

Under observation there were 189 patients with trophic ulcers of the lower extremities of venous genesis (CEAP VI class). In 78 patients conservative treatment was used with the low intensity laser radiation. Complex treatment consisted of preliminary preparing the ulcers and the following correction of the venous blood flow was used in 111 patients. 82 patients were treated by traditional methods disregarding the data of ultrasonic diagnosis. Laser therapy of ulcers by our original techniques and correction of the venous blood flow using new technologies and considering the data of duplex scanning was used in 29 patients, the best nearest and long-term results of the treatment being obtained in patients of this clinical group.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bandages; Blood Flow Velocity; Female; Follow-Up Studies; Humans; Hydroxyethylrutoside; Low-Level Light Therapy; Male; Middle Aged; Ointments; Prospective Studies; Retrospective Studies; Treatment Outcome; Ultrasonography, Doppler, Duplex; Varicose Ulcer; Vascular Surgical Procedures

The ulcers, located below the knees and remaining for 6 weeks and more, are called trophic leg ulcers. The leg ulcers of different etiology disable 0.8-1% of total Earth population. It was found that blood vessel problems in legs account for more than 80% of ulcers; even 65% from these are caused by venous diseases. In Lithuania about 8000 patients suffer from venous trophic ulcers. Regardless of modern methods the treatment of leg ulcers remains an extremely expensive process. The treatment cost of trophic ulcers is the highest of all surgical wounds and also requires a lot of personal investments. In order to assess the efficiency of autodermoplastics in the treatment of large venous ulcers in legs a prospective study was carried out of 111 patients who were treated in the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital from January 2001 to January 2004. The data was analyzed exceptionally of the operated 54 patients with venous origin ulcers open for more 6 months or exceeding 50 cm2. The above-mentioned patients were prepared for surgery by dressing the wounds with hydrocolloid Granuflex bandages and were operated by transplanting a 0.2-0.3 mm thick skin graft. The results were estimated by the surgeon during the dressings after the operation. The graft was taken in 35 (64.81%) cases; in 19 (35.19%) cases the graft was partially not taken and there were no cases when it was not taken at all. We came to the conclusions that skin graft transplantation is efficient in treatment of trophic venous leg ulcers larger than 50 cm2 and cures the trophic leg ulcers of vein origin completely in 2-3 weeks for 64.81% patients.

Topics: Adult; Aged; Aged, 80 and over; Bandages; Colloids; Female; Follow-Up Studies; Hematologic Agents; Humans; Hydroxyethylrutoside; Length of Stay; Male; Middle Aged; Pentoxifylline; Postoperative Care; Preoperative Care; Prospective Studies; Random Allocation; Sampling Studies; Skin Transplantation; Time Factors; Treatment Outcome; Varicose Ulcer; Vasoconstrictor Agents

Topics: Capsules; Hemorrhoids; Humans; Hydroxyethylrutoside; Phlebitis; Rutin; Varicose Ulcer; Varicose Veins