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Tratamiento de la ulcera venosa con escleroespuma versus manejo conservador

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dc.contributor.advisorRamírez Gómez, Miguel Antonio
dc.creatorFajardo Chavarro, Ernesto
dc.creatorNieves Pinzón, Ernesto
dc.creatorCamacho, Elver Alirio
dc.creatorRamírez Gomez, Miguel
dc.creator.degreeEspecialista en Cirugía General
dc.date.accessioned2013-05-14T13:37:53Z
dc.date.available2013-05-14T13:37:53Z
dc.date.created2013-04-23
dc.date.issued2013
dc.descriptionLa úlcera venosa es una revelación clínica severa de la insuficiencia venosa crónica. Es la causa del 54-76% de las úlceras venosas de miembros inferiores. La ciencia médica ha generado diversos procedimientos en el manejo de esta patología, es así como a partir de conocimientos en fisiopatología de la ulceración venosa, se han aplicado procedimientos como opción de tratamiento. Objetivos: Valorar si el uso de rutina de la oclusión endoluminal con espuma guiada por ecografía del sistema venoso superficial insuficiente, en adicción al manejo convencional de la ulcera venosa (vendaje no compresivo, gasa vaselinada y curaciones) podría mejorar la tasa de curación a las 24 semanas de tratamiento. Diseño: Estudio clínico aleatorizado prospectivo de pacientes de la consulta externa de cirugía vascular del Hospital Occidente de Kennedy-Bogotá, durante el 01 de junio del 2011 hasta el 30 junio del 2012. Métodos: Un total de 44 pacientes con ulcera activa que cumplieron criterios de selección ingresaron al estudio, correspondientes a 48 extremidades con clasificación CEAP (C6), los pacientes fueron a aleatorizados a manejo convencional (control) o con manejo adicional de oclusión endoluminal con espuma eco-guiada. El objetivo principal fue el cierre de la ulcera a las 24 semanas. Resultados: La Curación de la ulcera a las 24 semanas de la aleatorización fue de 20 (83.3%) extremidades del grupo de oclusión endoluminal con espuma eco-guiada Vs 3(12.5%) para el grupo de control P: 0.0005 Discusión: Las tasas de curación de la ulcera luego de la oclusión endoluminal con espuma eco-guiada es muy superior al manejo convencional con curaciones y vendaje no compresivo, las tasa de curación son tan altas como las reportadas con sistemas de alta compresión y cirugía a las 24 semanas. La oclusión endoluminal eco-guiada es segura, mínimamente invasiva y clínicamente efectiva.spa
dc.description.abstractVenous ulcer is a severe clinical revelation of chronic venous insufficiency. It is the cause of 54-76% of venous ulcers of the lower limbs. Medical science has generated various procedures in the management of this pathology, as well as from knowledge in pathophysiology of venous ulceration, procedures have been applied as a treatment option Objective: The aim of this study was to determine the rate of healing ulcers of the superficial venous system with conventional treatment (not compression bandages, vaseline gauze, and wound care) exclusively, versus the use of conventional treatment added to ultrasound-guided foam endoluminal occlusion. Methods: Prospective randomized clinical trial with patients attending the Vascular Surgery consult of the Hospital Occidente de Kennedy-Bogotá during the second semester of 2011 and first semester of 2012. 44 patients with ages 18 and over with venous insufficiency and active venous ulcer C6 in the CEAP classification and ankle-brachial index (ABI) greater than 0.8 were included. In total 48 extremities were analyzed; one group was treated with endoluminal occlusion with ultrasound-guided foam in the superficial venous system by Tessari method using 1% lapidium hydrochloride (Sklerol) added to conventional treatment (not compression bandages, vaseline gauze, and wound care), and the other group was treated exclusively with conventional treatment. Controls were made at month one, three, and six. Results: The healing rate of the ulcer at week 24 was 20 (83.3%) extremities healed of the endoluminal occlusion with ultrasound-guided foam group vs. 3(12.5%) extremities healed for the conventional treatment group (p=0.0005). Discussion: The healing rates of the venous ulcer after endoluminal occlusion with ultrasound-guided foam is far superior to conventional treatment with not compression bandages, vaseline gauze, and wound care exclusively. Healing rates with conventional treatment added to endoluminal occlusion with ultrasound-guided foam are as high as those reported with high compression bandages and surgery at 24 weeks. Endoluminal occlusion with ultrasound-guided foam is safe, minimally invasive and clinically effective - See more at: http://repository.urosario.edu.co/handle/10336/4436#sthash.PmaDEkfd.dpufeng
dc.format.mimetypeapplication/pdf
dc.format.tipoDocumentospa
dc.identifier.doihttps://doi.org/10.48713/10336_4421
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/4421
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Cirugía Generalspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.ccAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARÁGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectcompresión de enfermedades vascularesspa
dc.subjecttrombosis venosaspa
dc.subjectmediasspa
dc.subjectvendasspa
dc.subjectdispositivo de compresión neumática intermitentespa
dc.subjectrevisiónspa
dc.subject.keywordcompression of vascular illnesseseng
dc.subject.keywordveined thrombosiseng
dc.subject.keywordyou mediateeng
dc.subject.keywordyou blindfoldeng
dc.subject.keyworddevices of intermittent pneumatic compressioneng
dc.subject.keywordrevieweng
dc.subject.lembEnfermedades vasculares::Tratamientospa
dc.subject.lembEscleroespuma::Utilizaciónspa
dc.subject.lembInsuficiencia venosa::Tratamientospa
dc.subject.lembLinfedema::Tratamientospa
dc.subject.lembProcedimientos endovascularesspa
dc.titleTratamiento de la ulcera venosa con escleroespuma versus manejo conservadorspa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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