الفهرس 
Anatomy of venous system of lower limbOnly 14 pages are availabe for public view
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Abstract
Leg ulceration affects 15–18 per 1000 adults in developed countries, and is associated with pain and lower quality of life The majority of leg ulcers are secondary to venous insufficiency (venous ulcers). It has been estimated that the management of venous ulcers in the UK costs £100–300 million every year, nursing time accounting for most of this cost.
There is different lines of management for venous ulcer by medical, surgical, dressing, negative pressure and compression stocking.
This study included 100 patients presented to the vascular surgery department at faculty of medicine -Menoufia University with chronic venous ulcer. Patient randomized into two group (group A, group B). group A started four layer compression bandage after preparation and group B become under four layer compression bandage with negative pressure wound therapy. The procedure, possible complications, benefits, risks and other alternative interventions were all explained to the patients and an informed consent was obtained.
We evaluated the size of the ulcer in both groups after 15 days of treatment and we detected significant differences in ulcer size and percentage of ulcer healing between both groups. The mean size of the ulcer had reduced from 8.72 to 6.63 cm2 (56% healing) in NPWT group, whereas in the 4 layer compression group, the mean size had reduced from 8.1 to 7.71 cm2 (14% healing), with statistical significant difference between the two groups. The healing rate of the ulcer was statistically significant higher in the NPWT group (13.1 mm2 /week) than control group (2.8 mm2 /week). After 30 days of treatment, 34 ulcers (68%) in NPWT group had revealed 90% healing with mean duration of 24 days needed for healing while only (14%) in control group had completed 90% healing after that duration of the same size. The remaining 15 ulcers (32%) of NPWT group showed mean healing percentage of 70% of original ulcer size after 30 days of treatment.
Finally we recommend NPWT with compression therapy yields better results than four layer compression therapy alone. Despite of high cost combared with four layer compression therapy, it resemble a life boat for venous ulcer patients. We recommend more clinical trial with prolonged follow-up to assess clinical efficacy of NPWT.