Ron Bush, M.D. Introduces the TIRS Technique (Terminal Interuption of Reflux Source); Improvements in the Healing of Venous Ulcers

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A new technique has been developed which aids in the healing of venous ulers. It is documented that most ulcers treated with this technique have healed in 3-8 weeks.

I am overwhelmed with the results of Dr. Bush's treatments. I am now living a pain free normal life after 20 years of suffering., M.

Chronic venous insufficiency with venous ulcers affects approximately one to two people per 1000 of the general population a year. A review of the literature reveals the ulcer-healing rate to be low with as many as fifty percent of venous ulcers open and unhealed at 9 months. There is a high rate of recurrence with up to one third of patients suffering their third or fourth episode. Venous ulcers affect quality of life. In the United States, venous ulcers are estimated to cause the loss of 2 million working days per year and treatment cost can be as high as 3 billion dollars per year (Bergen et al., 2006).

When the pressure gets too high in the venous system, chronic venous insufficiency occurs. The increased pressure can occur in the superficial system, deep system or both. With long standing high venous pressure, ulceration can occur. This causes a breakdown of tissues that usually occurs around the ankles.

Often times, patients with venous ulcers are not treated appropriately and consult many specialists. Multiple wound care regimens are tried. Surgical procedures can be done but these may or may not correct the underlying problem.

Ronald G. Bush, MD FACS, Midwest Vein & Laser Center, Dayton, Ohio, has developed a technique called ‘Terminal Interruption of Reflux Source’ (TIRS). First the vascular specialist completes an ultrasound and examines the area around the ulcer. The purpose of the examination is to find vessels that are causing the high pressure. Using foam sclerotherapy, the physician then closes off these vessels. This reduces the high venous pressure in the area of the ulcer, which facilitates wound healing. This technique greatly accelerates the healing process with the average healing time within 6-8 weeks.

Dr. Bush describes the TIRS technique in an on-line course, available through his website for $199 (plus a $30 processing/certificate fee). Lectures are accredited through the University of Toledo for 2 CME credit hours. A certificate may also be issued to nurses.

For physicians/medical professionals interested in learning more about this technique, please visit or contact Peggy Bush, Advance Practice Nurse at pbush(at)bushvenouslectures(dot)com

By Peggy Bush, APN, CNS, MSN


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