Venous Leg Ulceration

Chronic venous leg ulceration (VLU) is a common recurrent problem in the elderly population and may result in immobility, with 45% of patients being housebound (Baker & Stacey 1994). As a result, individuals with VLU frequently experience depression, anxiety, social isolation, sleeplessness and reduced working capacity (Leach 2004). CVI, which is characterised by an increase in capillary permeability, inflammatory reactions, decreased lymphatic reabsorption, oedema and malnutrition of tissues, is a precursor to VLU. As HCSE increases venous tone while reducing venous fragility and capillary permeability and possesses anti-oedematous and antiinflammatory properties, it has been speculated that by improving microcirculation, ulceration may be delayed or prevented (Blaschek 2004).

A preliminary 12-week triple-blind, randomised, placebo-controlled trial of 42 participants with active VLU suggested a potential role for HCSE; however, further large scale trials are required to fully elucidate the potential use in practice (Leach 2004). The second stage of this trial was a descriptive survey exploring current opinion and usage of such therapies. The author concluded that positive results from clinical trials may facilitate the incorporation of the extract into clinical practice, although the integration into mainstream medicine may be 'constrained by medical and organizational gate keeping' (Leach 2004).

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