{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:09:07Z","timestamp":1790345347642,"version":"4.1.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2010,1,29]],"date-time":"2010-01-29T00:00:00Z","timestamp":1264723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Phlebology"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:sec>\n                    <jats:title>Thesis<\/jats:title>\n                    <jats:p>Venous ulcers (VU) consume considerable resources in healthcare systems, up to 1% of healthcare budgets in industrialized countries. Best practice guidelines (GLs) incorporate evidence-based diagnostic and therapeutic recommendations in a cost-effective manner and have been associated with improved and less costly outcomes for many diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether there are common elements in GLs for VU and their evidentiary strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic analysis of GLs for VU that were identified through clinicaltrials.gov, a government-sponsored website, and from experts outside the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten of 12 GLs on VU (7 North America and 5 Europe) were evidence-based, with the majority using the GRADE method. Only two had been developed or updated within the last three years. Venous duplex and ankle ABIs were recommended in all. Debridement was suggested in two, while simple non-adherent wound dressings were favoured in nine, and hydrocolloid in two. Only one GL discussed a range of dressing options, dependent on the condition of the VU. High pressure multi-layer compression bandages were favoured in 10. Only two focused on the importance of improving ankle joint mobility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While there are numerous evidence-based GLs for VU, the majority may lag recent developments in the field. There is consensus on the elements for dressings and compression among the various GLs, which should facilitate the development of a common consensus GL, similar to that for DVT\/PE. To improve patient care and reduce wasted resources, it is imperative for specialty societies to develop this consensus document.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1258\/phleb.2009.009071","type":"journal-article","created":{"date-parts":[[2010,1,29]],"date-time":"2010-01-29T14:03:52Z","timestamp":1264773832000},"page":"3-10","source":"Crossref","is-referenced-by-count":46,"title":["The role of perforators in chronic venous insufficiency"],"prefix":"10.1177","volume":"25","author":[{"given":"T F","family":"O'Donnell","sequence":"first","affiliation":[{"name":"Venous Center, Tufts Medical Center, Director of the Venous Centers at Tufts Medical Center and Dedham Medical Associates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,1,29]]},"reference":[{"key":"bibr-PHLEB-09-071C1","first-page":"143","volume":"22","author":"Homans J","year":"1916","journal-title":"Surg Gynecol Obstet"},{"key":"bibr-PHLEB-09-071C2","first-page":"300","volume":"24","author":"Homans J","year":"1917","journal-title":"Surg Gynecol Obstret"},{"key":"bibr-PHLEB-09-071C3","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193804000-00013"},{"key":"bibr-PHLEB-09-071C4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(70)90044-9"},{"key":"bibr-PHLEB-09-071C5","volume-title":"Current Techniques in Vascular Surgery","author":"O'Donnell TF","year":"2001"},{"key":"bibr-PHLEB-09-071C6","first-page":"59","volume":"14","author":"Hauer GH","year":"1985","journal-title":"VASA"},{"key":"bibr-PHLEB-09-071C7","volume-title":"Atlas of Venous Surgery","author":"O'Donnell TF","year":"1992"},{"key":"bibr-PHLEB-09-071C8","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)80020-6"},{"key":"bibr-PHLEB-09-071C9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2003.09.017"},{"key":"bibr-PHLEB-09-071C10","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.129642"},{"key":"bibr-PHLEB-09-071C11","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(99)70001-7"},{"key":"bibr-PHLEB-09-071C12","first-page":"52","volume":"18","author":"Whiteley MS","year":"2003","journal-title":"Phlebology"},{"key":"bibr-PHLEB-09-071C13","unstructured":"VonLoder, Anatomische tafeln tex. 1803. 2nd"},{"key":"bibr-PHLEB-09-071C14","unstructured":"GayJ. On varicose diseases of the lower extremities. The Lettsomian Lectures of 1867. London: Churchill"},{"key":"bibr-PHLEB-09-071C15","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)70016-2"},{"key":"bibr-PHLEB-09-071C16","first-page":"435","volume":"26","author":"Warren R","year":"1948","journal-title":"Surgery"},{"key":"bibr-PHLEB-09-071C17","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195309000-00014"},{"key":"bibr-PHLEB-09-071C18","first-page":"495","volume":"137","author":"Bjordal RI","year":"1971","journal-title":"Acta Chir Scand"},{"key":"bibr-PHLEB-09-071C19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(76)92714-8"},{"key":"bibr-PHLEB-09-071C20","doi-asserted-by":"publisher","DOI":"10.1177\/026835559000500207"},{"key":"bibr-PHLEB-09-071C21","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70059-X"},{"key":"bibr-PHLEB-09-071C22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.06.017"},{"key":"bibr-PHLEB-09-071C23","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800750514"},{"key":"bibr-PHLEB-09-071C24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.04.053"},{"key":"bibr-PHLEB-09-071C25","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2002.1871"},{"key":"bibr-PHLEB-09-071C26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16353-8"},{"key":"bibr-PHLEB-09-071C27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.038"},{"key":"bibr-PHLEB-09-071C28","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2009.09s007"},{"key":"bibr-PHLEB-09-071C29","doi-asserted-by":"publisher","DOI":"10.2310\/6670.2007.00068"},{"key":"bibr-PHLEB-09-071C30","doi-asserted-by":"publisher","DOI":"10.1177\/1531003508327921"},{"key":"bibr-PHLEB-09-071C31","first-page":"162","volume":"33","author":"Proebstle TM","year":"2007","journal-title":"Dermatol Surg"},{"key":"bibr-PHLEB-09-071C32","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2008.008016"},{"key":"bibr-PHLEB-09-071C33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.04.046"},{"key":"bibr-PHLEB-09-071C34","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2009.008090"},{"key":"bibr-PHLEB-09-071C35","first-page":"219","volume":"24","author":"Sokolov AL","year":"2009","journal-title":"Phlebology"},{"key":"bibr-PHLEB-09-071C36","unstructured":"ChangDW, LevyD, HayashiRM,\n                      Percutaneous Catheter Treatment of Perforating Vein Incompetence Using Ultrasound Guided Radiofrequency Ablation.\n                      Paper presented at Annual Meeting of the Society for Clinical Vascular Surgery, Coral Gables, FL, 2005"},{"key":"bibr-PHLEB-09-071C37","unstructured":"LumsdenA, ChangD, PedenE,\n                      Ultrasound-guided Percutaneous Radiofrequency Obliteration of Perforating Vein Incompetence.\n                      Paper presented at Annual meeting of the Society for Clinical Vascular Surgery, Las Vegas, NV, March 2006"},{"key":"bibr-PHLEB-09-071C38","unstructured":"KabnickL.\n                      Perforator Vein Treatment.\n                      Paper presented at the Vein Meeting Uncasville, CT. 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