Compression stockings in the prevention and treatment of venous ulcers

March 18, 2013

  • Compression stockings in the prevention and treatment of venous ulcers
  • Classification
  • Appointment
  • Use and Care

 Compression stockings prophylaxis treatment of venous ulcers
 Gradient compression stockings - long known for the treatment and prevention of venous leg ulcers. Previously, doctors often recommend wearing a four-layer compression bandages, but because of their inconvenience, not all patients wore them so often and so long as it was necessary for effective treatment. An alternative dressings can be graded compression tights Compression stockings - check with your doctor  Compression stockings - check with your doctor
   or socks to the knee. How and why it is prescribed to patients wearing compression stockings Compression knitwear - observe the following rules  Compression knitwear - observe the following rules
 How to choose the correct size and grade of tights or golf?

An estimated worldwide from leg ulcers suffer tens of millions of people. Most ulcers (70%) is caused by venous disease; recurrences are frequent, approximately one third of patients - more than once. Gradient compression is considered an important part of the treatment of varicose veins and / or venous ulcers; They can be used both for the active treatment of ulcers as well as for their prophylaxis.

 Compression stockings in the prevention and treatment of venous ulcers

Pathophysiology

To ensure adequate venous return (the amount of venous blood flowing from the veins back to the heart), superficial and deep veins, butterfly valve and calf muscles must work in concert .  Deep veins carry blood to the legs up toward the heart .  These include two posterior tibial veins, tibial veins, two front and two peroneal vein which above are connected to form the popliteal vein, which in turn is connected to the femoral vein .  These veins are located deep in the muscle tissue of legs and protected fibrous connective tissue .  Large amount of blood flowing in these veins leads to a strong pressure on the vein walls .  Superficial veins, which include great saphenous Vienna, Vienna and small saphenous veins connecting them, are less blood, and account for much weaker pressure .  Superficial veins are connected to the deep veins by means of perforated veins .  Butterfly valve, which are in superficial and deep veins, provide the blood flow in one direction .  When these valves are working properly, they prevent regurgitation of the deep veins in the surface .

The mechanical energy required for the blood rose up through the vessels, provided the calf muscles that walking rhythmically contracting and relaxing. Reduced calf muscle pushing blood up from one to another segment of the vein; regurgitation is prevented by valves. Relaxation of the calf muscle allows the empty segment again filled with blood from the superficial veins, and so the cycle repeats.

When the valve starts to function properly, the cycle of blood flow occurring in one direction is broken, and the blood starts to flow back. The problem is particularly serious when a reverse current occurs between the deep and superficial veins, as the pressure increase inside surface resulting in further disruption of the valves. This is because the flap valve by stretching the vein wall can no longer normally closed segments of veins. The overall result of the increased surface of hydrostatic pressure is the emergence of twisting, convex varicose veins.

If this condition is not treated, in the long term it can lead to chronic venous insufficiency Venous insufficiency - rapidly Youthful disease  Venous insufficiency - rapidly Youthful disease
 , The result of which, in turn, can be swelling, lipodermatosclerosis, varicose eczema and venous ulcers.

 Compression stockings in the prevention and treatment of venous ulcers

Gradient Compression

External compression allows for constant, controlled pressure on the skin. This ensures support of the superficial venous system, the hydrostatic pressure is reduced and restored the balance between deep and superficial veins. This helps reduce swelling and improve venous return.

The physiological effects of pressure gradient

Increases:

The rate of blood flow in the deep veins;

Development of prostacyclin;

The local capillary blood flow;

Indicator transcutaneous oxygen pressure;

The release of plasminogen activator.

Decreases:

The volume and pressure of blood in veins;

Visible surface varicose veins;

Swelling;

Symptoms limfodermatoskleroza;

Venous pressure.

Unlike compression dressings, that create a particularly strong pressure when a person is physically active, tights provide the most intense compression, when the human body is at rest (including, and when he is sitting at work). The pressure is monitored by the limited ability to stretch tights; thereby having an impact on not well-functioning valves, increasing venous return, fibrinolytic activity increases venous walls, and the risk of thrombosis Thrombosis - the cause of heart attack and stroke  Thrombosis - the cause of heart attack and stroke
 On the contrary, reduced.

Tights with gradient compression creates externalities (external) pressure, which most strongly in the area of ​​the lower leg (not less than 14 mm Hg. Art.) And gradually decreases at the level of the lower leg and thigh. This increases the rate of blood flow within the deep venous system. How much pressure is necessary to achieve good therapeutic results, it is still a matter of debate, but experts admit that the force of compression will depend on the extent of the disease. For example, severe venous hypertension is associated with complications such as edema, eczema, pigmentation disorders of the skin, sealing veins and ulceration. In the treatment of this disorder requires a stronger compression than for the treatment of patients with less severe disease, such as mild forms of varicose veins and swelling.

Warfarin - indirect anticoagulants

July 26, 2009

  • Warfarin - indirect anticoagulants
  • Indications for admission

 Warfarin
 Warfarin - a drug belonging to the class of anticoagulants (blood thinners). It reduces the risk of blood clots by blocking the formation of certain substances that promote blood clotting. Warfarin is used to prevent heart attacks, strokes, blood clots in the veins and arteries.

Initially warfarin began to produce as a means to deal with rats and mice, but after a few years, it has been found that it is effective and relatively safe drug for the prevention of thrombosis and embolism, which occur in many disorders. The use of warfarin as the drug was approved in the mid-20th century, and it still remains a very popular drug.

 Warfarin - indirect anticoagulants

Before taking the drug

Strict contraindications to warfarin are pregnant and allergic to any ingredient of the drug. Also, before you take warfarin, be sure to tell your doctor if you have any of these violations:

  • Hemophilia or any other disease associated with increased risk of bleeding;
  • Anemia, low platelet count, or other disorder associated with blood cells;
  • The presence of blood in urine and / or blood expectoration of sputum;
  • Infection of the lining of the heart (bacterial endocarditis);
  • Stomach or intestinal bleeding or ulcers;
  • Recently, the head trauma, aneurysm or bleeding in the brain.

Usually, warfarin is not assigned to people with alcoholism and mental disorders. It can also be dangerous in the following cases:

  • Patient age over 65 years;
  • The presence of kidney disease in a patient;
  • Cancers;
  • High blood pressure and / or severe heart disease;
  • Diseases somehow affecting the blood vessels of the brain.

During the course of treatment with warfarin must use effective contraception. Pregnancy during treatment is likely to lead to miscarriage Miscarriage - can you protect yourself from it?  Miscarriage - can you protect yourself from it?
   or having an abortion.

Warfarin should be taken with extreme care for disorders such as:

  • Celiac disease;
  • Diabetes;
  • Liver disease;
  • Congestive heart failure;
  • Overactive thyroid The thyroid gland - is responsible for your hormones  The thyroid gland - is responsible for your hormones
 ;
  • Connective tissue diseases, such as Sjogren's syndrome, scleroderma Scleroderma - affects all the organs  Scleroderma - affects all the organs
 , rheumatoid arthritis Arthritis - a variety of forms and complications  Arthritis - a variety of forms and complications
 Or lupus.

 Warfarin - indirect anticoagulants

Side effects

The rarest and most dangerous side effect of warfarin is a severe allergic reaction to the drug. Its symptoms: shortness of breath, an extensive skin rash, swelling of the face, lips, tongue and throat. When such symptoms should seek urgent medical help.

Stop taking warfarin and contact the doctor if the following side effects:

  • Pain, swelling, feeling cold or hot, diskoloratsiya skin anywhere on the body;
  • Sudden and severe pain in the legs;
  • Sudden headache, dizziness, and weakness;
  • Bleeding from the nose, mouth, vagina or rectum without damage;
  • Bleeding, resulting from damage which can not be stopped;
  • Easy bruising;
  • The presence of blood in urine, stool, sputum, or vomit;
  • Pallor, nausea or shortness of breath, increased heart rate, trouble concentrating;
  • Dark urine, yellowish tint of the skin and / or whites of the eyes;
  • Pain in the abdomen and / or back;
  • Numbness or muscle weakness;
  • Any diseases accompanied by diarrhea, fever, chills, body aches and symptoms similar to flu symptoms.

Much more often, however, there are less serious side effects of warfarin:

  • Nausea, vomiting, mild stomach pain;
  • Bloating and flatulence;
  • Changes in sense of taste.

 Warfarin - indirect anticoagulants

Drug Interactions

Many drugs can affect the action of warfarin, so consult with your doctor before taking any medications during the course of treatment. Such drugs include, in particular, acetaminophen, aspirin, celecoxib, ibuprofen, diclofenac, indomethacin, naproxen, piroxicam, and others.

You should also limit your intake of foods rich in vitamin B (such as liver, herbs and vegetable oils). Vitamin K reduces the effectiveness of warfarin.

Drinking alcohol increases the risk of manifestation of certain side effects of warfarin.





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