The involvement of the microcirculation in chronic
venous insufficiency (CVI) due to venous
hypertension causes venous hypertensive microangiopathy (VHM) and venous ulceration. VHM is characterized by the presence of enlarged convoluted capillaries; microvascular
thrombosis with obliteration of some capillaries; increase in flux, permeability, and
edema; and altered function of microlymphatics. PO2 is decreased and CO2 increased. Capillary exchanges are altered, and nutritional alterations eventually lead to
venous ulcers.
Edema is associated with increased capillary pressure, reduced clearance, and an increased exchange surface of capillaries, which become tortuous and glomerular-like. The aim of this randomized, placebo-controlled study was to evaluate the effect of local treatment with
Essaven gel (EG) in 28 subjects with venous microangiopathy due to severe CVI and
ulcers treated with a single acute application, Measurements of
laser Doppler flux, PO2 and PCO2 in standardized conditions of application showed positive microcirculatory changes (significant decrease of the abnormally increased flux and CO2 while PO2 increased) in the EG treatment group. Changes in the placebo and control group were more limited (changes in the placebo group were mainly associated with skin manipulation when placebo-EG was applied). In conclusion,
Essaven gel, in comparison with placebo, acutely improves the microcirculation in VHM even with a single application.