Background: Chronic wounds, including venous ulcers and diabetic foot ulcers, impose significant clinical and economic burdens globally. Compression therapy is a cornerstone intervention, yet its optimal application timing and management strategies lack standardized guidelines.

Methods: According to the ‘6S’ evidence resource model, evidence retrieval is searched from the top-down and collected relevant guidelines, best practices, evidence summaries, systematic reviews and expert consensus. The retrieval time limit was from the database establishment to 20 March 2025. Two reviewers independently screened and evaluated the literature, and then extracted and summarized the evidence according to the JBI grading of evidence and recommendation system.

Results: This study summarizes 18 pieces of evidence in 7 aspects, including indications, contraindications, application, assessment, management strategies, effectiveness, and adverse reactions, related to the application timing and management strategies of compression therapy for chronic wounds.

Conclusions: Compression therapy significantly enhances chronic wound healing but requires rigorous contraindication screening and dynamic pressure adjustment. Clinicians should adopt evidence-based protocols integrating ABI assessments and patient education. Future innovations should focus on smart devices and longitudinal outcome tracking.

Keywords: Chronic wound management; Compression therapy; Venous ulcers; Evidence based guidelines; Contraindications.

The mechanism of new method cancer treatment operates via targeting Warburg effect of cancer metabolism. The mechanism of new method cancer treatment creates via combination “Prolonged medical starvation” with considerably decreased dosage of cytotoxic drugs. This combination leads to destroy “aerobic oxidation in Glycolysis” of mechanism Warburg effect (Figure 1). There were substantiated the viewpoint of thermodynamic biophysical and biochemical descriptions of the mechanism Warburg effect causing oncogenesis mechanism which is destructed by the new method cancer treatment creating transiting from quasi-stationary pathologic state of an organism into normal stationary state of an organism and cells of an organism via mechanism maintenance stability Into via formular Energy and Internal Medium according to first law of thermodynamics via Formula H = U + W(int) + W(Ext) [H - Enthalpy (Common Energy), U - Internal Energy, W(int) - Internal Work, W(Ext) - External Work], i.e. stability of Internal Energy (∆U) (stable temperature 36,0°C - 36,9°C, stability of pH = 7,35 etc.) [1-4]. There are as the positive influence Environment on a human organism as well as negative influences Environment on a human organism which can be as inorganic substances influences as well as organic substances influence even by living organisms how bacteria and viruses. The defensive mechanism of immune and hormonal systems of an organism resists the negative influences of pathologic substances and organisms how bacteria and viruses. Considering mechanisms of oncogenesis in different states of an organism, there were described mechanisms of oncogenesis with Cancer Tumor Metastases in neglected state of an organism either mechanism of resistance to anticancer cytotoxic drugs or mechanism of relapsed cancer disease causing by survival oncogenes viruses via suppressed immune systems and hormonal systems causing by large dosage cytotoxic drugs of modern methods cancer therapy. Firstly, neglected cancer disease cannot be complete treated by modern methods chemotherapy with large dosage of cytotoxic drugs because large doses of cytotoxic drugs create suppression defensive mechanisms of immune and hormonal systems. Secondly, The prevalence etiologic factors over organism’s defensive immune and hormonal systems stimulates driving mechanisms of transmutation normal cells into cancer cells which lead to development of cancer disease. The prokaryotic organisms of oncologic viruses (v-oncogenes) have no the electron transport chain via five Complexes of respiratory system as opposed of the other prokaryotic organisms of different bacteria. All eukaryotic organisms including human organism have electron transport chain via five Complexes of respiratory system. Therefore oncologic viruses (v-oncogenes) live in cancer cells of the human organisms. Oncologic viruses (v-oncogenes) affect cells’ nuclei of weak place of extracellular tissue which is supplied with lack of Basic Internal Energy (Ebas ) causing by lack of hormonal support. Lack of cellular walls’ of hormonal support results in disbalance intercellular cellular chemical potential (µinter.cell ) & extracellular chemical potential (µouter.cell ). Thus oncologic viruses (v-oncogenes) affect deep level of stem cells maybe Unipotent stem cells or even Oligopotent stem cells due to lack of energy from Basic Internal Energy (Ebas ) in deep level of these stem cells which lead to find other cells of an organism with enough deep level energy from Basic Internal Energy. Thus these mechanisms create Metastases.

The use of herbal extracts in treatment by “prolonged medical starvation for 42-45 days”

New method cancer treatment uses “Prolonged medical Starvation” which is supplemented with considerably decreased dosage cytotoxic substances [5-7]. “Prolonged medical Starvation during 42 - 45 days” of an organism is supported with herb extracts [sage, hawthorn, horse-tail, (stinging-)nettle, ninety-knot, hypericum, ergot, St.John’s wort, etc.] providing with small dosage of cytotoxic activity of red cranesbill (Geranium robertianum) and used abundant liquid drink including water up to 1,5-2,0 liter per day [5-7]. The herbal extracts should be filtered through a triple gauze layer in order that any fibre must not remain in the extract. The herbal extracts fill the organism during “Prologed medical Starvation 42-45 days” for supplementing with necessary microelements and vitamins, especially folic acid, that is necessary for hemopoiesis and decreases also acidification in the blood of the organism by “Prolonged medical Starvation”. During the “Prolonged medical Starvation” it’s necessary to look after the common health state of the person and especially state of gastrointestinal tract that it occurs the bowels open /timely evacuation of excrements/, that there will not be constipation /retention of feces/. The disturbance of gastrointestinal activity should be healed with vegetable laxatives, activated charcoal, medicaments and use an enema if it’s necessary.

The starvation leaving should been taken place during 7 days with gradual addition of products: Juices, then watery decoctions and gels, then vegetable pulps, then baked fruits and vegetables, then liquid kasha (dish of cooked grain), then mashed potatoes, then pair of cutlets - and up to the usual nutrition [8,9,10]. The diet shouldn’t be salted during leaving starvation [8,9,10].

The used “prolonged medical starvation 42-45 days” with very small dosage and weak cytotoxic substances

The treatment by “Prolonged medical Starvation (during 42 45 days)” is providing with small dosage of cytotoxic activity of red cranesbill (Geranium Roberti Anum) and used abundant liquid drink including water up to 1,5-2,0 liter per day [10,11] causing considerable decrease almost of all depots of an organism exhausting organism’s fat and hydro carbonic depots, that leads to competition between cancer tissue and an organism for the use of remained decreased depot for maintenance stability Internal Energy of a depressive organism (U org) (normal temperature 36.0°C-37.0°C by which all enzymes operate and other indices). Thus, this competition between the organism and the cancer must lead to the win for most strong one. But the protective forces of the depressive organism become stronger due to support with herbal extracts including also small dosage of cytotoxic activity of red cranesbill (Geranium robertianum), delivering vitamins and microelements into the organism [10,11]. Besides increase of fat metabolism from fat depot leads to augmentation glutation peroxide GPX and phospholipid hydroperoxide glutathione peroxide (PHGPX) in all cells of an organism which neutralize redundant superoxide [O*] and ROS/H2 O2 /free radicals in G1/S phases cellular cycle of cancer cells cycle suppressing excessive proliferative processes of cancer cells [10,11-15]. Suppression accelerating cellular cycle in cancer cellular cycle leads to decrease anabolic processes in condition of “Prolonged medical Starvation” with small dosage of cytotoxic activity of red cranesbill (Geranium robertianum) which is exerting normal nuclear DNA [nDNA] work, decreased replication via prevailing Mitosis over Meiosis in complex Mitosis-Meiosis phase [13-15]. Eliminating partial suppression of Anaerobic processes of oxidative phosphorylation by “Prolonged medical Starvation” restores normal balance Aerobic oxidative processes & Anaerobic processes of oxidative phosphorylation in mitochondria of cancer cells decreasing ROS in mitochondria of cancer cells causing suppression of excessive nucleus DNA replication with normalization of cellular cycle of cancer cells and elimination irrepressible proliferative processes of cancer growth [3,6,7,11-13]. Also, complex Mitosis-Meiosis phase of cancer cellular cycle is broken into separate Mitosis and Meiosis where haploid Meiosis phase of viral cellular cycle is deprived due to prevailing state over diploid Mitosis phase normal cellular cycle [11-13]. Besides broken covalent bonds between Mitosis and Meiosis, deprive barriering defense of viral pluripotent stem cells function causing normal cellular cycle with activity of diploid Mitosis phase in cancer cells [10,11-13]. Expression Mitosis in normal cellular cycles of all cells incite T cells [T lymphocytes] via appearance produced immunoglobulins CTLA-4 and PD-1, and resonance waves of cellular capacitors T memory cells learn and remember waves function of viral substances 21 containing in separated haploid Meiosis phase. Then T memory cells exert T helper cells, and T helper cells stimulate T killer cells and B cells for production antibodies against cancer viral substances of haploid Meiosis phase which is deprived barriering defense of covalent bonds between Mitosis and Meiosis causing loss viral pluripotent stem cells function. The going out from “Prolonged medical Starvation (during 42-45 days)” must be occurred from 7 days till 12 days with gradual increased quantity and extension quality food.

The mechanisms of cancer tumors metastases in neglected state of an organism

The overload of “Nodal Point of Bifurcation Anabolic and Catabolic Processes” [NPBACP] with partial suppression catabolic exergonic anaerobic processes occurs due to shift balance anabolic endergonic processes & catabolic exergonic anaerobic processes into excessive anabolic endergonic processes in cancer metabolism according to Warburg effect [4,18-26] (Figures 1, 2 and 3). Thus increased the anabolic endergonic processes in cancer tissues of neglected organism leads to deep losses of considerable decrease almost of all depots of an organism especially exhausting organism’s fat and hydrocarbonic depots via their substances because of increased anabolic endergonic processes of cancer tumor in neglected state of a human organism becoming lean [4,18-22]. Besides this violated balance anabolic biosynthetic processes & catabolic anaerobic processes cause violation balance catabolic aerobic processes & catabolic anaerobic processes into prevalence aerobic processes of respiratory oxidation over partial suppressed anaerobic processes of oxidative phosphorilation in cancer metabolism because Human cells’ mitochondrial oxygen of catabolic anaerobic processes are taken by oncologic viruses (v-oncogenes) having no respiratory electron transport chain [4,6,18-22]. The prevalence aerobic processes of respiratory aerobic oxidation over anaerobic processes of oxidative phosphorilation leads to disbalance between mitochondrial aerobic respiratory oxidative function and anaerobic oxidative phosphorilation of link Glycolysis - Krebs Tricarboxylic Acids Cycle (TCA) according to Warburg effect [4,5,6,18-22] (Figures 4 and 5). As concerning of the absence respiratory electron transport chain with five Complexes in oncologic viruses (v-oncogenes), this prevalence aerobic processes of respiratory oxidation in cancer cells provide oncologic viruses (v-oncogenes) with cellular mitochondrial respiratory electron transport chain. However the oncologic viruses (v-oncogenes) are intensive replicated and find respiratory activity in respiratory electron transport chain of new heathy cells which are affected by oncoviruses of cancer cells via transiting the new cancer calls of metastasis in new organs. Thus increased quantity metastases create neglected state of cancer ill organism. Just cells’ mitochondrial aerobic oxidative function produces stable quantity Oxygen ions [O-2] via operation of cytochrome system [cytochrom C, cytochrom c-oxidase, cytochrom P450 etc.] in cancer cells because of delivering stable quantity Oxygen (O2 ) by Hemoglobin system in blood corresponding to stable Respiratory Index [CO2 /O2 = 0,8 1,0] in an organism. Produced in Krebs tricarboxylic acids cycle (TCA) Hydrogen ions (H+) react with Oxygen (O2 ) and form Water (H2 O) that must eliminate Oxygen from liquids of an organism tissue and cells of an organism [4,6,9,10,18-22] (Figures 4 and 5). However the supplementary Oxygen (O2 ) does not find sufficiently Hydrogen ion (H+) to react with Oxygen (O2 ) and does not produce supplementary Water (H2 O) [4,6,9,10,17-22]. Therefore this supplementary Oxygen (O2 ) adds electron, due to Reactive Oxygen Species (ROS) operation, and is transformed into superoxide (O2 *) which generates free radicals. Free radicals exert DNA replications in G2 phase of cellular cycle via inducing reaction 2nDNA replication [5,6]. Partial suppression catabolic processes of Krebs Tricarboxylic Acids Cycle (TCA) decreases quantity of Hydrogen ions (H+) production in cancer metabolism. The insufficiency of Hydrogen ions (H+) production causes abundance superoxide (O2 *) inducing excessive quantity of ROS/ H2 O2 /free radicals which exert accelerative DNA replications via inducing accelerative reaction 2nDNA reactions in cancer cells [4,5,6,11,12,18-22]:

*OH + H₂-nDNA-DNA ––> H₂ O + H•-nDNA-DNA;

*O*+ 2H₂ O ––> 2H• + 2OH¯;

2H•-nDNA-DNA + 2H• ––> 2nDNA-H• + 2nDNA-H•;

2nDNA-H• + 2*OH ––> 2nDNA + H₂ O

The induce nDNA replication in G2 phase cellular cycle, and also the free radicals (*OH and H•) are neutralized in final G2 phase of nDNA replication as in cancer cells as well as in normal cells [5,6,11,12,18-22]. Then it occurs M phase of cellular cycle, i.e. Mitosis in cell division. Thus moderate cellular replication occurs in norm due to production moderate quantity ROS/ H2 O2 /free radicals in able-bodied cells and occurs via G○ , G1/S, G2, M phases cellular cycle. The accelerated cycle of cancer cell is induced by accelerated cycle of v-oncogene initially and then is continued via affecting cancer nuclei by excessive quantity ROS/H2 O2 /free radicals produced in cancer cells’ mitochondria. The accelerated cellular cycle of cancer cells leads to shortening cancer cellular cycle without G○ and G1 phases cellular cycle that creates excessive cellular replication of cancer cells. The perpetual affecting cancer cells by excessive quantity of ROS/H2 O2 /free radicals cause irrepressible cancer tumor growth which also supports by some growth factors as EGF, FGFs, HGF, HDGF, GDF9, IGFs and so on [5,6,11,12,18 22]. Furthermore the irrepressible cancer tumor growth leads to partial suppression catabolic anaerobic oxidative processes due to overloaded “nodal point of bifurcation anabolic and catabolic processes” [NPBac] with consumption great quantity energy and Acetyl-CoA that impede excretion via oxidative destruction of great quantity high-molecular substances which produced by excessive anabolic processes of cancer metabolism [4,6,9,10,18-22]. Therefore the excretion of great quantity high molecular substances are produced via huge anabolic processes that occurs within cancer cells (Figure 1). Thus there are formed many metastases in neglected organism. Besides the partial suppression catabolic anaerobic processes in cancer tissue touches also on Krebs Tricarboxylic Citric Acids cycle [TCA] via partial suppression mechanism transferring Oxaloacetates from cancer tissue TCA to cancer cells’ TCA [4,5,6,10,18-22) (Figures 4 & 5). The overload NPBac with partial suppressed mechanism transferring Oxaloacetates from cancer tissue TCA to cancer cells’ TCA results in expression mechanism metastasis due to blocking oxidative destruction of synthesized high molecular substances in cancer tissue [4,6,9,10,18-22] (Figure 5 & 6). Also operations of an organism cells’ cellular capacitors via resonance waves promote movement cancer cells with the synthesized high-molecular substances within them into healthy tissue without overload “Nodal point bifurcation anabolic and catabolic processes [NPBac] and lack of Acetyl CoA” for oxidative destruction high-molecular substances and cause metastases into the healthy cells of healthy tissues of different organs where these healthy cells are changed itself into cancer cells of cancer tissue.

The cancer metastases in neglected state of an organism are destructed via efficient treatment of cancer disease by the new method cancer treatment

The state of “Prolonged medical Starvation (during 42-45 days)” bereaves of some substances from anabolic biosynthetic processes that prevent to effect of cells by v-oncogenes impeding of shift balance anabolic endergonic processes & catabolic exergonic processes into excessive anabolic endergonic processes [4,14,15,23-26]. Hence absent of excessive anabolic endergonic processes of cancer tissue and excessive quantity of mitochondria catabolic aerobic electron transport chain processes that lead to absent mechanism forming metastases and development of cancer cells [11,12,15,23-26]. Thus overloaded “nodal point of bifurcation anabolic and catabolic processes” [NPBac] with consumption great quantity energy and Acetyl-CoA in “Prolonged medical Starvation (during 42-45 days)” leads to depression cancer development [4,15,19,23-26]. Besides it prevents of forming Warburg effect as mechanism of cancer development. Also the new method cancer treatment use “Prolonged medical Starvation (during 42-45 days)” for depression cancer activity of forming metastases, and use very small dosage of cytotoxic substances which don‘t suppress activity of immune systems and hormonal systems. Therefore hormones with herbal vitamins’ cofactors of an organism’s metabolic biochemical processes promote maintenance stability Internal Energy (Uorg ) of an organism in state of “Prolonged medical Starvation (during 42-45 days)” that supports stability as balance anabolic biosynthetic processes & catabolic anaerobic phosphorilation of oxidative processes as well as balance catabolic aerobic oxidative processes & catabolic anaerobic phosphorilation of oxidative processes. Also very small dosage of cytotoxic substances destruct of some depressed mechanism of cancer development, and then immune T cells phagocytosis with B cells antibodies creates complete destruction of oncologic mechanisms leading to recovery of the organism (Figure 6). However the cancer metastases in neglected state of an organism are appeared in all organs of an organism including in living organs which create impossible treatment of cancer disease by both new method cancer treatment as well as modern method cancer therapy with large dosage cytotoxic drugs. Hence there are the some incurable in neglected state of cancer disease which cannot be to cure ever by new method cancer treatment.

Figure 1: : The metabolism of a malignant tumor tissue and of a normal tissue.

Figure 2: Influences of energy flow on interactions catabolic processes and anabolic processes in norm and in cancer pathology. Balance of interactions catabolic processes and anabolic processes in norm.

Figure 3: The influences general regulation biochemical processes on Internal Energy.
Determining stability internal chemical potentials of an organism (µ), normal cells (µ) and cancer cells (µ*).

Figure 4: Krebs Tricarboxylic Acids Cycle (TCA) in catabolic exoergonic process.

Figure 5: Interaction between anaerobic catabolic processes and aerobic catabolic processes via Krebs tricarboxylic acids cycle.

Figure 6: The targets of both the new method cancer treatment and modern method of cancer treatment.
Balance of interactions catabolic processes and anabolic processes in norm.

Therefore a doctor must determine following queries: 1) Have oncological patient cachectic state of Health entirely? 2) Have the oncological organism many inoperable metastases or the metastases into life support organs how the brain, the lungs, the hepar etc. 3) Have the oncological organism very bad state of Health due to excruciating common pain or local pain in life support organs? c) Had oncological organism losing common activity? The oncologic Doctor must take for treatment only the patients without these negative symptoms or syndrome of such neglected oncological diseases.

Acknowledgments: This article is dedicated to the memory of my daughter T.M. Ponisovska.

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