Compression stockings·Venous disorders

Together Forward… toward

v-WINdonesia-Weltkongress 2024

From Bauerfeind Life on 26.08.2024

Kurz & Knapp Prof. Sergio Gianesini looks forward for moving “together forward”, as per the line of the v-WINdonesia World Congress, with all the vein and lymphatic global community toward appropriate patient management, including clinical trials and real world data analysis. In this context, appropriate compression is considered a fundamental pillar, not only for the patients, but also for all the subjects exposed to a higher risk of venous and lymphatic hypertension. Highlights of Prof. Gianesini interview include the following concepts:

  • Phlebology and Lymphology are strictly united and must be managed together.
  • Current vein-lymphatic guidelines are strongly limited by a questionable methodology and a consequent significant heterogeneity in the global scenario. Real world evidence integration is mandatory.
  • Compression remains a pillar in vein-lymphatic management and its prescription should carefully address only properly certified and validated products.
  • Proper compression even in healthy subjects exposed to prolonged standing demonstrated clinical and cost-effectiveness benefits.
  • Misinformation and fake-news dissemination is a challenge to be counteracted in the vein-lymphatic field, as per the v-WINter 2022 published document.
  • v-WINdonesia World Congress (Bali Island, Oct 22-26,2024) will offer a unique chance of hands-on, live cases and top frontal lectures on all the most important aspects of vein and lymphatic care, offering everyone the chance to present the personal experience, while discussing with the most renowned key opinion leaders from all continents.

Prof. Sergio Gianesini, top Academic Surgeon at Ferrara University (Italy) and Uniformed Services University of Health Sciences (Bethesda, USA), is one of the most prominent Key Opinion Leaders and trendsetters in the vein-lymphatic field. He is the Founding President of the v-WIN Foundation and President of UIP for the 2023-2027 term. Before the v-WIN Congress in Bali in October, Michelle Schaub, Head of Product Management Phlebology, spoke to him for Bauerfeind life about compression, work on guidelines and websites including misleading disinformation.

Professor Gianesini, you were elected to be the new President of the International Union of Phlebology (UIP), an office you will hold until 2027. What objectives do you have for your term in office?

Prof. Sergio Gianesini: Advocating for Phlebology and Lymphology to be properly practiced around the world and represented in front of the different nations’ clinical governance bodies. Also for this reason we’re considering upgrading the name of the International Union of Phlebology (UIP) in World Union of International Phlebo-lymphology, in order to showcase the global representation of this Organization that groups together 81 Scientific Societies.

You’re also the Founding President of the “Venous-lymphatic World International Network (v-WIN) Foundation”. So you’ll be able to tell us about your motivation for your networking activities and the key reasons for setting up the v-REGISTRY research database.

Prof. Gianesini: Venous-lymphatic World International Network foundation was founded by myself, Prof. Chi (in representation of North America and Asia) and Prof. Bottini (for Latin America).  The organization has always been characterized by inclusiveness for all the colleagues interested in promoting evidence-based appropriate growth in vein-lymphatic practice and science. This has been clearly demonstrated by the 2019 v-WIN congress leading to the publication of a large document on similarities and controversies on global guidelines, as it happened following the 2022 meeting with the publication of another very large paper on evidence-based data in vein-lymphatic medicine. The following step, associated with the upcoming v-WINdonesia World Congress, is the creation of a unique multi-lingual global platform allowing everybody to include real world data so to properly answer to the current clinical governance need of trials and of real world evidence.

Michelle Schaub, Head of Phlebology Product Management, conducted the interview with Prof. Sergio Gianesini for Bauerfeind life.

What priority do you assign to compression therapy when treating venous disorders?

Prof. Gianesini: Compression was, is and will be the pillar of our everyday vein-lymphatic management. This is particularly true if we consider the population is aging and becoming more sedentary, and therefore more prone to venous hypertension. At the same time, it’s fundamental proper compression is applied in terms not just of dose, but also in terms of stiffness and material quality. In this sense, a careful education of both patients and healthcare professionals is mandatory to avoid the use of not properly certified and validated products.

What is your take on the knowledge transfer of technical aspects of products from the manufacturer to the user, for example relating to circular knit versus flat knit or compression classes?

Prof. Gianesini: In v-WIN we have always left a significant educational room to compression technical experts, in order to transmit to both patients and colleagues those notions that too often are not properly taken into consideration and that are actually making a difference between “proper compression” and “whatever compression”. Certification and regulatory aspects on this topic should be far more divulgated in our community, in order to prescribe better and to obtain also a better compliance of the patients, that, according to the literature, is lost mainly not because of the product but because of the wrong prescription.

What kind of big trends, what challenges can you expect in the world of phlebology?

Prof. Gianesini: The first one we highlighted in v-WIN is the validity of the so called guidelines. Indeed, too many times we are reading documents that are actually consensus rather than methodologically appropriate guidelines. Even more, it was quite surprising to notice in our dedicated publication how many discrepancies can be found in different groups guidelines, highlighting the need of coworking together better at a global level. The second challenge is medical online misinformation. According to pubmed, more than 40% of the medical website contains misinformation. For this reason we published 100 pages dedicated to evidence-based vein-lymphatic communication, together with 12 layman’s term multi-lingual pages of sum up dedicated to the patients.  A third challenge that we must manage better is the pro-active collaboration with the companies: indeed, in particular for the devices, new products can enter the market quite easily, but a proper post-market surveillance is needed to verify what is truly valuable and what is just a commercial claim. This is true both in the Phlebology and in the Lymphology field and indeed I see as big trend in the unification of these two fields. Another trend I notice is the growing push of technology in offering apparently appealing solution for vein-lymphatic care: while this is welcomed in order to improve the results, it’s also mandatory that proper attention is developed in the appropriate validation and surveillance of these innovations. In fact, a fundamental trend we have to promote is the proper selection of the patient, for the proper treatment, after careful evaluation of the proper risk factors of that same individual.

Why is considering phlebology and lymphology together so important?

Prof. Gianesini: Because they are a “family affair”, as described in a nice editorial of already 10 years ago. We must imagine them as rivers and creeks, strictly interconnected. Only in this way we can really offer a cure to our patients, rather than just a treatment of a diseased vein or lymphatic vessel. This is particularly clear in compression use, where we can act synergically on both, focusing on the macro and microcirculation at the same time, both in patients and in healthy subjects at risk of developing vein-lymphatic drainage impairment, such as long standing up workers, obese subjects and whoever is in general prone to edema.

The vascular systems and the lymphatic system are closely connected and should always be considered together.

Bauerfeind at the v-WIN World Congress
v-WINdonesia World Congress is already showcasing the features of a historic meeting, welcoming 77 nations delegations from all around the world, under the line of “Together Forward”. In the world of Prof. Sergio Gianesini “the most renowned Key Opinion Leaders will move together forward indeed toward appropriateness in vein-lymphatic care, with a strong focus on real world evidence thanks to the v-Registry Global project”.
Bauerfeind is a proud partner of this worldwide action that will include a strong focus on the importance of appropriate compression use. A dedicated workshop will be available for the attendees, together with the possibility of presenting personal real world evidence on the compression use. Everybody is invited to send her/his comment on already published literature, agreeing or disagreeing with it and presenting the personal experience. For more info visit here.

Pictures: privat, Andreas Wetzel

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