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3. Management of patients with infected aortic prosthesis. Analysis of 164 patients from the Italian Registry of Graft Infection (IRGI) [Modalità di trattamento nei pazienti con infezione di protesi aortica. Analisi di 164 pazienti dal R

Author

Speziale F, Rizzo L, Schioppa A, Brizzi V, Fiorani P, Cao P, Zannetti S, Parlani G, Agrifoglio G, Alagni G, Alberti D, Alò F, Bacciu P, Biglioli P, Bortolani E, Brotzu G, Caldarelli G, Canova G, Cavaliere P, Costarella S, Crescenzi B, D'Addato M, De Blasis G, De Donato G, Deriu G, Di Cintio V, Florena M, Franchi A, Mangialardi N, Moretti V, Muzj A, Odero A, Palombo D, Pedeferri G, Pistolere GR, Placida C, Ponzio E, Pratesi C, Puttini M, Rabitti C, Setacci C, Spartera C, Spigonardo F, Stancanelli V, Valitutti P, Vecchiati E, Vecchioni R., CHIESA , ROBERTO, Speziale, F, Rizzo, L, Schioppa, A, Brizzi, V, Fiorani, P, Cao, P, Zannetti, S, Parlani, G, Agrifoglio, G, Alagni, G, Alberti, D, Alò, F, Bacciu, P, Biglioli, P, Bortolani, E, Brotzu, G, Caldarelli, G, Canova, G, Cavaliere, P, Chiesa, Roberto, Costarella, S, Crescenzi, B, D'Addato, M, De Blasis, G, De Donato, G, Deriu, G, Di Cintio, V, Florena, M, Franchi, A, Mangialardi, N, Moretti, V, Muzj, A, Odero, A, Palombo, D, Pedeferri, G, Pistolere, Gr, Placida, C, Ponzio, E, Pratesi, C, Puttini, M, Rabitti, C, Setacci, C, Spartera, C, Spigonardo, F, Stancanelli, V, Valitutti, P, Vecchiati, E, and Vecchioni, R.

Published
2002

6. Modalità di trattamento nei pazienti con infezione di protesi aortica. Analisi di 164 pazienti dal Registro Italiano delle Infezioni Protesiche (IRGI)

Author

Speziale, F., Rizzo, L., Schioppa, A., Brizzi, V., Fiorani, P., Cao, P., Zannetti, S., Parlani, G., Agrifoglio, G., Alagni, G., Alberti, D., Alò, F., Bacciu, P., Biglioli, P., Bortolani, E., Brotzu, G., Caldarelli, G., Canova, G., Cavaliere, P., Chiesa, R., Costarella, S., Crescenzi, B., D'Addato, M., De Blasis, G., De Donato, G., Deriu, G., Di Cintio, V., Florena, M., Franchi, A., Mangialardi, N., Moretti, V., Muzj, A., Odero, A., Palombo, Domenico, Pedeferri, G., Pistolere, G. R., Placida, C., Ponzio, E., Pratesi, C., Puttini, M., Rabitti, C., Setacci, C., Spartera, C., Spigonardo, F., Stancanelli, V., Valitutti, P., Vecchiati, E., and Vecchioni, R.

Subjects
Postoperative complications, Prosthesis related infections, diagnosis, Aortic diseases, diagnosis, Intestinal fistula, diagnosis, Prosthesis related infections, diagnosis, Cardiology and Cardiovascular Medicine, Aortic diseases, Intestinal fistula
Published
2002

7. Imipenem/cilastatin (1.5 g daily) versus meropenem (3.0 g daily) in patients with intra-abdominal infections: Results of a prospective, randomized, multicentre trial

Author

Basoli, Antonio, Chirletti, Piero, Paolo, Mazzocchi, Vincenzo, Speranza, Lezoche, E., Guerrieri, M., Marrano, D., Minni, F., Giulini, S. M., Nodari, F., Brotzu, G., Loddo, P., Latteri, F., Scuderi, Gianluca, Rodolico, G., Cavallaro, L., Donini, I., Sortini, A., Tonelli, F., Spini, S., Natale, C., Musto, V., Vio, A., Verdecchia, G., Morgagni, D., Mariani, L., Montefusco, A., Gerosa, E., Tiberio, G., Nardone, A., Mazzeo, F., Benassai, G., D'Amico, D., Tropea, A., Piervittori, M., Becelli, S., Cazzaniga, M., Stagnitti, F., Crucitti, F., Pacelli, F., Gargiulo, A., Panichi, Giovanni, DI ROSA, Roberta, Porzio, R., Lombardi, U., Stipa, V., Chirletti, P., De Anna, D., Pisano, I., Armenio, S., Salvestrini, E., Baglioni, A., Iafrate, G., Donadio, F., Paron, L., Saccia, A., Di Girolamo, P., A., Basoli, E. Z., Meli, P., Mazzocchi, V., Speranza, E., Lezoche, M., Guerrieri, D., Marrano, F., Minni, S. M., Giulini, F., Nodari, G., Brotzu, P., Loddo, F., Latteri, G., Scuderi, G., Rodolico, L., Cavallaro, I., Donini, A., Sortini, F., Tonelli, S., Spini, C., Natale, V., Musto, A., Vio, G., Verdecchia, D., Morgagni, L., Mariani, A., Montefusco, E., Gerosa, G., Tiberio, Nardone, GERARDO ANTONIO PIO, F., Mazzeo, Benassai, Giacomo, D., Damico, A., Tropea, M., Piervittori, S., Becelli, M., Cazzaniga, F., Stagnitti, F., Crucitti, F., Pacelli, A., Gargiulo, G., Panichi, R., Dirosa, R., Porzio, U., Lombardi, V., Stipa, P., Chirletti, D., Deanna, I., Pisano, S., Armenio, E., Salvestrini, A., Baglioni, G., Iafrate, F., Donadio, L., Paron, A., Saccia, and P., Digirolamo

Subjects
Adult, Male, Microbiology (medical), Imipenem, Meropenem, law.invention, Randomized controlled trial, law, Abdomen, polycyclic compounds, medicine, Humans, Protease Inhibitors, Prospective Studies, Infusions, Intravenous, Prospective cohort study, APACHE, Aged, General Immunology and Microbiology, Cilastatin, business.industry, Imipenem/cilastatin, Bacterial Infections, General Medicine, Middle Aged, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Anti-Bacterial Agents, Clinical trial, Treatment Outcome, Infectious Diseases, Tolerability, Anesthesia, Female, Thienamycins, business, medicine.drug
Abstract

30 citazioni su Scopus. 46 citazioni su GoogleScholar. ------ http://www.scopus.com/record/display.url?eid=2-s2.0-0347771343&origin=resultslist&sort=plf-f&src=s&sid=1BklTwBDkRxWaxt9FLi7YAz%3a70&sot=aut&sdt=a&sl=37&s=AU-ID%28%22Benassai%2c+Giacomo%22+6602920646%29&relpos=11&relpos=11&searchTerm=AU-ID(\"Benassai, Giacomo\" 6602920646) ------ An open-label prospective, randomized, parallel multicentre study was undertaken to compare the efficacy and tolerability of 1.5 g/day intravenous imipenem/cilastatin with 3 g/day intravenous meropenem in the treatment of intra-abdominal infections, A total of 287 patients mere enrolled; 201 patients, divided between the 2 treatment groups, were evaluable. Clinical outcome, bacteriological outcome, untoward microbiological effects, and clinical and laboratory adverse experiences mere evaluated, 98% of patients receiving imipenem/cilastatin therapy mere cured, with 96% showing eradication of infection, 95% of those on meropenem mere cured, with 98% showing eradication. These differences in clinical and bacteriological outcome between the 2 treatments were not statistically significant, Two patients receiving imipenem/cilastatin and 5 receiving meropenem had untoward microbiological effects. There mas a 0.7% frequency (1/139 patients) of possibly or probably drug-related clinical or laboratory adverse experiences with imipenem/cilastatin and a 2.7% frequency (4/148) with meropenem, The mean time to defervescence was significantly less for patients in the imipenem/cilastatin treatment group than for those receiving meropenem. This study shows that 1.5 g/day of imipenem/cilastatin is equivalent to 3.0 g/day meropenem in clinical and bacteriological outcome, as well as in incidence of side effects.

Published
1997

10. PRESENTATION OF THE RIFLE PROJECT RISK-FACTORS AND LIFE EXPECTANCY

Author

Menotti, A., Farchi, G., Conti, S., Giampaoli, S., Lanti, M., Mariotti, S., Scanga, M., Seccareccia, F., Spagnolo, A., Verdecchia, A., Dicarlo, G., Dima, F., Marenco, G., Falchero, M., Ideo, G., Caspani, B., Podda, M., Zuin, M., Ferrario, M., Cesana, Gc, Devito, G., Sega, R., Tenconi, Mt, Laddomada, Ms, Devoti, G., Dobrilla, G., Depetris, G., Angelini, Gp, Okolicsanyi, L., Toso, S., Nassuato, G., Passera, D., Ambrosio, Gb, Tasso, S., Bittolobon, G., Moro, E., Alessandrini, P., Soldan, S., Feruglio, Ga, Vanuzzo, D., Pilotto, L., Carulli, N., Loria, P., Dilengite, M., Bozzoli, M., Salvioli, Gf, Lugli, R., Gaddi, A., Sangiorgi, Z., Daddato, S., Minardi, A., Descovich, Gc, Dormi, A., Barbara, L., Festi, D., Alvisi, V., Balhous, W., Buzzelli, Gp, Giusti, A., Giacchi, M., Fatighenti, D., Giotti, M., Laurenzi, M., Ricci, G., Bucci, A., Antonini, R., Pacioni, F., Angelico, F., Delben, M., Lalloni, L., Azzarri, L., Ricci, P., Attili, Fa, Desantis, A., Urbinati, Gc, Fazio, S., Pannozzo, F., Sotis, Gl, Righetti, Gm, Mancini, M., Farinaro, E., Panico, S., Trevisan, M., Krogh, V., Jossa, F., Celentano, E., Rocco Galasso, Albano, O., Palasciano, G., Misciagna, G., Guerra, V., Muntoni, S., Pintus, P., Podda, E., Stabilini, M., Frulio, T., Brotzu, G., Pulina, S., Trudu, A., Sanna, A., Baule, Gm, Avellone, G., and Digarbo, V.

Subjects
RISK FACTORS, LIFE EXPECTANCY, MORTALITY, PREDICTION
Published
1993

13. Surgical treatment of hydatidosis

Author

Loi, A, Mannu, B, Montisci, R, Pinna, Ad, Talloru, M, Savona, G, Pinna, Cd, Dettori, G, Noya, Giuseppe, and Brotzu, G.

Subjects
hydatidosis
Published
1991

14. Xenotransplantation of microencapsulated pancreatic islets contained in a vascular prosthesis: preliminary results

Author

L Pibiri, G. Basta, M A De Giudici, R Calafiore, Brotzu G, P Brunetti, Palmina Petruzzo, and A. Falorni

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Adolescent, Swine, medicine.medical_treatment, Xenotransplantation, Islets of Langerhans Transplantation, Biocompatible Materials, Iliac Vein, Iliac Artery, Fibrin, Diabetes Mellitus, Experimental, Dogs, Blood vessel prosthesis, Internal medicine, Diabetes mellitus, Alloxan, medicine, Animals, Humans, Bioprosthesis, geography, Transplantation, geography.geographical_feature_category, biology, business.industry, Insulin, Pancreatic islets, Anastomosis, Surgical, medicine.disease, Islet, Blood Vessel Prosthesis, Endocrinology, medicine.anatomical_structure, biology.protein, Female, business
Abstract

Porcine and human pancreatic islets were microencapsulated in an alginate-polylysine biomembrane and put in a chamber of a new vascular prosthesis composed of an inner tubing of Dacron mesh and an outer tubing of expanded polytetrafluorethylene material. The vascular prosthesis was anastomized between the iliac artery and the contralateral vein of diabetic dogs. The recipients did not receive any immunosuppressive therapy. Function of porcine and human islets was monitored by measuring serum glucose levels and human C-peptide concentrations. After transplantation, serum glucose levels were maintained at values lower than 200 mg/dl, and C-peptide concentrations were between 0.8 and 3.2 ng/ml. Injected insulin requirements decreased by 50%-60%. Four to 8 weeks after transplantation, histologic examination showed well-preserved and functioning islets in the majority of intact microcapsules. Fibrin and inflammatory cells were not observed in the chamber. These data suggest long-term survival and function of microencapsulated pancreatic islets in the vascular prosthesis.

Published
1991

30. Management of patients with infected aortic prosthesis. Analysis of 164 patients from the Italian Registry of Graft Infection (IRGI) | Modalità di trattamento nei pazienti con infezione di protesi aortica. Analisi di 164 pazienti dal Registro Italiano delle Infezioni Protesiche (IRGI)

Author

Speziale, F., Rizzo, L., Schioppa, A., Brizzi, V., Fiorani, P., Cao, P., Zannetti, S., Parlani, G., Agrifoglio, G., Alagni, G., Alberti, D., Alò, F., Bacciu, P., Biglioli, P., Bortolani, E., Brotzu, G., Caldarelli, G., Canova, G., Cavaliere, P., Chiesa, R., Costarella, S., Crescenzi, B., D Addato, M., Blasis, G., Donato, G., Deriu, G., Di Cintio, V., Florena, M., Franchi, A., Mangialardi, N., Moretti, V., Muzj, A., Odero, A., Palombo, D., Pedeferri, G., Pistolere, G. R., Placida, C., Ponzio, E., Pratesi, C., Puttini, M., Rabitti, C., Setacci, C., Carlo SPARTERA, Spigonardo, F., Stancanelli, V., Valitutti, P., Vecchiati, E., and Vecchioni, R.

40. In vitroInhibition of Infectivity of Polio Viruses by Guanidine

Author

LODDO, B., FERRARI, W., BROTZU, G., and SPANEDDA, A.

Abstract

THE presence of a guanidine moiety in a number of antiviral drugs1–5prompted us to investigate whether some simple guanidine derivatives may reduce the infectivity of viruses for cultured mammalian cells. The following compounds were examined: guanidine hydrochloride, aminoguanidine bicarbonate, creatine hydrate, arginine, uridine, urea, thiourea, decyl- and dodecyl-bis-guanidine, N,N′-bis(beta-hydroxyethyl)biguanide. The chemicals dissolved in water were boiled for about 15 min. and then added to the culture media.

Published
1962
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47. Balancing donor and recipient risk factors in liver transplantation: the value of D-MELD with particular reference to HCV recipients

Author

Avolio, A, Cillo, U, Salizzoni, M, DE CARLIS, LUCIANO GREGORIO, Colledan, M, Gerunda, G, Mazzaferro, V, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, De Carlis, L, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, De Waure, C., Avolio A.W., Cillo U., Salizzoni M., De Carlis L., Colledan M., Gerunda G.E., Mazzaferro V., Tisone G., Romagnoli R., Caccamo L., Rossi M., Vitale A., Cucchetti A., Lupo L., Gruttadauria S., Nicolotti N., Burra P., Gasbarrini A., Agnes S., Lirosi M.C., Miele L., Pompili M., Siciliano M., Perilli V., Gaspari R., Castagneto M., Tandoi F., Mangoni I., Belli L., Pinna A.D., Cescon M., Gridelli B., Li Petri S., Volpes R., Pinelli D., Fagiuoli S., Montalti R., Regalia E., Rossi G., Antonelli B., Berloco P., Lai Q., Risaliti A., Nicolini D., Valente U., Gelli M., Morelli N., Zamboni F., Tondolo V., Brotzu G., Ettorre G.M., Vennarecci G., Bresadola F., Baccarani U., Toniutto P.L., Manzia T., Anselmo A., Angelico M., Calise F., Scuderi V., Romano M., Rendina M., Barone M., Cuomo O., Perrella A., Santaniello W., Donataccio M., Dalle Ore G., de Ville de J., Monti L., Avolio, A W, Cillo, U, Salizzoni, M, De Carlis, L, Colledan, M, Gerunda, G E, Mazzaferro, Mariapia, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Montalti, Roberto, Avolio, A, DE CARLIS, L, Gerunda, G, Mazzaferro, V, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, and De Waure, C

Subjects
Graft Rejection, Male, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, Hepacivirus, Liver transplantation, Gastroenterology, Liver disease, Postoperative Complications, Retrospective Studie, UNSUSTAINABLE MATCH, Models, Risk Factors, Immunology and Allergy, Health Status Indicators, Age Factor, PROGNOSTIC INDICES, Pharmacology (medical), Health Status Indicator, D-MELD, Liver Transplantation, liver transplantation, Hazard ratio, Graft Survival, donor-recipient match, outcome, prognosis, risk factors, Age Factors, Trapianto epatico, Hepatitis C, Hepatitis B, Statistical, Middle Aged, Prognosis, Tissue Donors, Survival Rate, Italy, HCV, Female, Human, Adult, medicine.medical_specialty, Prognosi, Donor Selection, End Stage Liver Disease, Young Adult, Internal medicine, medicine, Humans, fattori di rischio, Aged, Retrospective Studies, Transplantation, Hepaciviru, Models, Statistical, business.industry, Donor selection, Risk Factor, Settore MED/09 - MEDICINA INTERNA, Odds ratio, medicine.disease, Settore MED/18, Surgery, body regions, Postoperative Complication, business
Abstract

Donor-recipient match is a matter of debate in liver transplantation. D-MELD (donor age × recipient biochemical model for end-stage liver disease [MELD]) and other factors were analyzed on a national Italian database recording 5946 liver transplants. Primary endpoint was to determine factors predictive of 3-year patient survival. D-MELD cutoff predictive of 5-year patient survival 1628). At 3 years, the odds ratio (OR) for death was 2.03 (95% confidence interval [CI], 1.44-2.85) in D-MELD class C versus B. The OR was 0.40 (95% CI, 0.24-0.66) in class A versus class B. Other predictors were hepatitis C virus (HCV; OR = 1.42; 95% CI, 1.11-1.81), hepatitis B virus (HBV; OR = 0.69; 95% CI, 0.51-0.93), retransplant (OR = 1.82; 95% CI, 1.16-2.87) and low-volume center (OR = 1.48; 95% CI, 1.11-1.99). Cox regressions up to 90 months confirmed results. The hazard ratio was 1.97 (95% CI, 1.59-2.43) for D-MELD class C versus class B and 0.42 (95% CI, 0.29-0.60) for D-MELD class A versus class B. Recipient age, HCV, HBV and retransplant were also significant. The 5yrsPS

Published
2011

48. A liposome-based formulation containing equol, dihomo-γ-linolenic acid and propionyl-l-carnitine to prevent and treat hair loss: A prospective investigation.

Author

Brotzu G, Fadda AM, Manca ML, Manca T, Marongiu F, Campisi M, and Consolaro F

Subjects
8,11,14-Eicosatrienoic Acid adverse effects, Administration, Cutaneous, Adult, Alopecia diagnosis, Alopecia physiopathology, Carnitine administration & dosage, Carnitine adverse effects, Drug Combinations, Equol adverse effects, Female, Hair Follicle growth & development, Humans, Liposomes, Male, Middle Aged, Pilot Projects, Prospective Studies, Scalp physiopathology, Time Factors, Treatment Outcome, 8,11,14-Eicosatrienoic Acid administration & dosage, Alopecia drug therapy, Carnitine analogs & derivatives, Equol administration & dosage, Hair Follicle drug effects, Scalp drug effects
Abstract

Hair loss is a common aesthetic disorder that can be triggered by genetic, inflammatory, hormonal, and environmental factors acting on hair follicles and their life cycle. There are several types of hair loss that differ in causes, symptoms, and spatial and temporal progression. Androgenic alopecia, a common form of hair loss, is the consequence of a decreased microcirculation of the scalp as well as the toxic action of elevated dihydrotestosterone levels on the hair bulbs. In the present study, the lotions TRINOV Lozione Anticaduta Uomo and TRINOV Lozione Anticaduta Donna, containing dihomo-γ-linolenic acid (DGLA), S-equol, and propionyl-l-carnitine, were tested on 30 men and 30 women (mean age of men was 46.6 ± 6.4 years; mean age of women was 49.5 ± 9.0) with signs of androgenic alopecia, respectively. DGLA is a precursor of the prostaglandin PGE1, which acts by improving microcirculation; S-equol inhibits 5α-reductases, thus preventing the transformation of testosterone into dihydrotestosterone; and propionyl-l-carnitine promotes lipid metabolism, stimulating energy production. These three molecules are loaded into liposomes for their effective transdermal delivery. Daily topical applications of the lotions resulted in a hair count that significantly increased for women and marginally increased for men after 6 months of treatment. Furthermore, significant increase in anagen hair and a significant decrease in telogen hair were observed starting from 3 months in male and 1 month in female patients. Thus, the formulations under investigation were effective in attenuating androgenic alopecia-related hair loss in men and women., (© 2018 Wiley Periodicals, Inc.)

Published
2019
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49. Percutaneous Endoscopic Transgastric Jejunostomy (PEG-J) Tube Placement for Levodopa-Carbidopa Intrajejunal Gel Therapy in the Interventional Radiology Suite: A Long-term Follow-up.

Author

Saddi MV, Sarchioto M, Serra G, Murgia D, Ricchi V, Melis M, Arca R, Carreras P, Sitzia L, Zedda S, Dui G, Rossi R, Ticca A, Melis M, and Cossu G

Abstract

Background: Percutaneous endoscopic gastrojejunostomy (PEG) and radiologically inserted gastrojejunostomy (RIG) are both safe and effective techniques for gastrojejunal tube placement. The authors compared these 2 procedures in patients with advanced Parkinson's disease (PD) who required the continuous intrajejunal delivery of a levodopa/carbidopa gel suspension (LCIG)., Methods: Outcomes were retrospectively collated from 30 PEG and 12 RIG procedures performed at 2 centers in patients with advanced PD for the delivery of LCIG., Results: Baseline clinical characteristics, incidence of early severe adverse events, late major complications, dropout, and the mean time-lapse of tube replacements were comparable in the PEG and RIG groups., Conclusion: The current results suggest that, in patients with PD, the RIG technique is as safe and effective as the endoscopic procedure, and it can be considered a valid option for patients who require LCIG when the endoscopic procedure is not available or unfeasible.

Published
2018
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50. Chronic venous ulcer treatment with fascial pedunculated graft.

Author

Montisci R, Ruju C, Massoni G, Sanfilippo R, and Brotzu G

Subjects
Chronic Disease, Hemodynamics, Humans, Microcirculation, Varicose Ulcer physiopathology, Wound Healing, Surgical Flaps blood supply, Varicose Ulcer surgery, Vascular Surgical Procedures
Abstract

Aim: Chronic venous ulcer treatment is often time consuming and requires a high degree of compliance from the patient. This derives not only from venous hypertension but also from chronic structural and metabolic changes of underlying tissues which impair the healing process. It therefore becomes necessary to improve the ulcer tissue condition in order to accelerate the healing process. This is obtained mainly with the improvement of local haemodynamics and secondly by direct action on the ulcer. The aim of the study is to evaluate the efficacy of a treatment with a pedunculated flap of fascia as an additional treatment of chronic venous ulcer., Methods: Four patients classified C6 according to the CEAP classification were treated for chronic venous ulcer with correction of venous hypertension (saphenectomy or ligature of incompetent perforating veins). The patients also underwent rotation of a fascial pedunculated flap transferred from the sural area to the perimalleolar area. After 7-15 days they had a free skin graft in the treated area., Results: All patients were discharged on the 3(rd) postoperative day after the flap rotation. In 3 patients the ulcer healed within 30 days and in a 4(th) patient within 45 days. No recurrence was observed., Conclusion: With this method the healing time seems to be shortened compared to the typical evolution in patients treated with only reflux control followed by conservative therapy. Associating fascial flap in the treatment of chronic venous ulcers improves the bed on which the free skin graft is applied. We can also hypothesize that this procedure restores the aponeurotic barrier between deep venous circulation and superficial microcirculation with the ensuing improvement in local venous hypertension.

Published
2003

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