Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers

Topical wound oxygen (TWO2) proposes an innovative therapy option in the management of refractory non-healing venous ulcers (RVU) that aims to accelerate wound healing. TWO2 accelerates epithelialisation. This leads to the development of a higher tensile strength collagen, which lessens scarring and the risk of recurrence. Sixty-seven limbs with 67 ulcers were managed using TWO2 therapy, and 65 limbs with 65 ulcers were managed using conventional compression dressings (CCD). The proportion of ulcers completely healed by 12 weeks was 76% in patients managed with TWO2, compared to 46% in patients managed with CCD (p < 0.0001). The mean reduction in ulcer surface area at 12 weeks was 96% in the TWO2 therapy group, compared to 61% in patients managed with CCD. The median time to full ulcer healing was 57 days in the TWO2 group, in contrast to 107 days in patients managed with CCD (p < 0.0001). TWO2 patients had a significantly improved Quality-Adjusted Time Spent Without Symptoms of disease and Toxicity of treatment (Q-TWiST) compared to CCD patients, denoting an improved outcome (p < 0.0001). TWO2 reduces the time needed for RVU healing and is successful in pain alleviation and MRSA elimination. TWO2 therapy radically degrades recurrence rates. Utilising diffused oxygen raises the capillary partial pressure of oxygen (Po2) levels at the wound site, stimulating epithelialisation, and granulation of new healthy tissue. Taking the social and individual aspects of chronic venous ulceration into account, the use of TWO2 can provide an overwhelmingly improved quality of life for long-time sufferers of this debilitating disease

Aorto-Uni-Iliac Stent Grafts with and without Crossover Femorofemoral Bypass for Treatment of Abdominal Aortic Aneurysms: A Parallel Observational Comparative Study

We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease. 537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR. We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B). Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities. Technical success was 97% (n=33) in group A and 85% (n=5) in group B (P=0.31). Primary and assisted clinical success at 24 months were 88% (n=30) and 12% (n=4), respectively, in group A, and 85% (n=5) and 15% (n=1), respectively, in group B (P=0.125). Reintervention rate was 10% (n=3) in group A and 0% in group B (P=0.084). No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period. AUI without crossover bypass is a viable option in selected cases