Using Physical Modalities in the Treatment of XXXX : A 14-year Comparative Clinical Study.

@entity1 @entity1066 @entity3179 @entity2850 @entity2827 @entity3096
@entity3179 are prevalent, challenging wounds; their incidence is rising with the increasing age of the general population. Physical mo- dalities often are used to help heal these chronic wounds. A prospective study was conducted to investigate the application of high-voltage stimu- lation (HVS), ultrasound therapy (US), low-level laser therapy (LLLT, 810 nm, 65 mW, 4 J/cm2), and @entity2850 ( @entity2850 ), with and without surgical intervention; along with standard of care comprising drug therapy (micronized @entity3096 fraction in two 500-mg tablets once daily) and wet dressings of 0.9% @entity2827 on venous leg @entity1066 . METHODS: The 305- @entity1 study was conducted between 1994 and 2008 among @entity1 with @entity3179 in 3 facilities in Poland. After surgery involving crossectomy, partial [short] stripping of the greater or short saphenous vein, local phlebectomy, and ligation of insufficient perforators, 4 groups of @entity1 were treated with the standard of care drug/dressing therapy and HVS, US, LLLT, or @entity2850 , and 1 group received the drug/dressing ther- apy only. Four non-surgical groups received HVS, US, LLLT, or @entity2850 and drug/dressing therapy, and 1 group received drug/dressing therapy only. Changes in wound area and volume were compared among all the groups receiving the various treatments using the Gilman index. In all groups therapy lasted 7 weeks. The computed planimetry method for observation of healing process was used. RESULTS: The Gilman index values at 4 weeks were significantly higher in the compression plus surgery compared with other groups (P = 0.01). After therapy for @entity1 from the @entity2850 + surgery group, the Gilman index was 1.18 cm (P  <= 0.001 compared with other groups). The percentage total surface area regression analysis confirmed that compression plus surgery is the most efficient in venous leg @entity1066 therapy (61.89% reduction after 4 weeks of therapy and 78.19% at the end of study) compared to the other groups (P  <= 0.001). The HVS and US appeared useful only in conservatively treated @entity1 (P < 0.05). The LLLT did not accelerate reduction of the ulceration surface. CONCLUSION: Venous surgery plus @entity2850 is the most effi- cient treatment for @entity3179 . Compression therapy should be provided to both surgically and conservatively non-surgically treated pa- tients. High-voltage stimulation and ultrasound therapy are useful meth- ods in conservative treatment of @entity3179 . For surgically treated @entity1 , these physical modalities are not effective. Low-level laser ther- apy is not an efficient method for treating @entity3179 .    .
