Treatment of Chronic Leg Ulcers in the Community: A Comparative Trial of Scherisorb and Iodosorb

1987 ◽  
Vol 2 (2) ◽  
pp. 115-121 ◽  
Author(s):  
A.J. Stewart ◽  
D.J. Leaper
Keyword(s):  
Healing Rate ◽  
Comparative Trial ◽  
Leg Ulcers ◽  
The Cost ◽  
Community Trials ◽  
Chronic Leg Ulcers

Ninety-five patients with chronic leg ulcers have been recruited from the community and randomized to have Scherisorb or Iodosorb dressings for the care of their ulcers. The overall healing rate at 10 weeks was 29% with no difference being found in the two dressing groups. The ulcers which healed had statistically significant higher basal temperature at entry to the trial (P< 0.05), were significantly smaller (P< 0.01), and had been present for the shorter time (P<0.01) compared with those which did not heal. Similar frequencies of dressing changes and time taken were found in both groups but the cost of treating a patient with Scherisorb was £3.33 compared with £4.68 for Iodosorb. We conclude that an acceptable healing rate was found with both dressings which is comparable with other community trials but that the addition of iodine as an antiseptic does not increase the chances of healing.

scholarly journals Skin grafting in the treatment of hard-to-heal leg ulcers

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Giovanni Mosti ◽  
Vincenzo Mattaliano ◽  
Pietro Picerni ◽  
Costantino Christou
Keyword(s):  
Ulcer Healing ◽  
Healing Rate ◽  
Skin Grafting ◽  
Leg Ulcers ◽  
Clinical Routine ◽  
Ulcer Size ◽  
Donor Skin ◽  
Post Traumatic ◽  
Chronic Leg Ulcers

Some risk factors or comorbidities may make Chronic Leg Ulcers (CLU) very difficult to heal. These ulcers are usually defined refractory ulcers and may require an in-hospital intensive care to increase the healing rate. Aim of this retrospective study was to assess if our clinical routine in hospitalized patients, made up with surgical debridement followed by donor skin grafting (allografts), may favor the ulcer healing. The records of 120 patients (55 males and 65 females; mean age 73.9±11.3 years) with ulcers greater than 100 cm2 and lasting for more than 1 year were analyzed. The median ulcer size was 165 cm2 (IQR 130-250 cm2; range 100-1000 cm2). The median ulcer duration was 24 months (IQR 16-32 months; range 12-300 months). The ulcer pathophysiology was venous in 74 patients, arterial in 21, mixed in 12, vasculitis in 5 and post-traumatic in 8 patients. After debridement the patients were submitted to allograft procedures (single or multiple) up to the ulcer healing. When allograft was able to create an effective granulation tissue and reduce the ulcer size an autograft was performed to get the ulcer closure. 109 patients healed and 11 were lost at follow-up. 65 patients healed just with one allograft in 16 weeks (IQR 13-21 weeks). 42 patients healed with 2 procedures in 20 weeks (IQR 18-23 weeks). 31 of them received a final autograft while 11 healed with two allografts. 2 patients with an ulcer surface of 200 cm2, both affected by CLI, healed with 3 allografts procedures in 40 and 33 weeks, respectively. Pain and exudate amount were significantly decreased and even disappeared after the first allograft. Allografts alone or followed by an autograft are able to get the ulcer healing also in case of extensive and long lasting ulcers refractory to all previous treatments.

Cost-effectiveness of superabsorbent wound dressing versus standard of care in patients with moderate-to-highly exuding leg ulcers

2020 ◽  
Vol 29 (4) ◽  
pp. 235-246
Author(s):  
Vladica M. Veličković ◽  
Paul Chadwick ◽  
Mark G. Rippon ◽  
Ivana Ilić ◽  
Emma Rose McGlone ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Wound Dressing ◽  
Healing Rate ◽  
Standard Of Care ◽  
Leg Ulcers ◽  
Expected Cost ◽  
The Cost ◽  
Quality Adjusted Life

Objective: To determine the cost-effectiveness/utility of a superabsorbent wound dressing (Zetuvit Plus Silicone) versus the current standard of care (SoC) dressings, from the NHS perspective in England, in patients with moderate-to-high exudating leg ulcers. Method: A model-based economic evaluation was conducted to analyse the cost-effectiveness/utility of a new intervention. We used a microsimulation state-transition model with a time horizon of six months and a cycle length of one week. The model uses a combination of incidence base and risk prediction approach to inform transition probabilities. All clinical efficiency, health-related quality of life (HRQoL), cost and resource use inputs were informed by conducting a systematic review of UK specific literature. Results: Treatment with the superabsorbent dressing leads to a total expected cost per patient for a six month period of £2887, associated with 15.933 expected quality adjusted life weeks and 10.9% healing rate. When treated with SoC, the total expected cost per patient for a six month period is £3109, 15.852 expected quality adjusted life weeks and 8% healing rate. Therefore, the superabsorbent dressing leads to an increase in quality-adjusted life weeks, an increase in healing rate by 2.9% and a cost-saving of £222 per single average patient over six months. Results of several scenario analyses, one-way deterministic sensitivity analysis, and probabilistic sensitivity analysis confirmed the robustness of base-case results. The probabilistic analysis confirmed that, in any combination of variable values, the superabsorbent dressing leads to cost saving results. Conclusion: According to the model prediction, the superabsorbent dressing leads to an increase in health benefits and a decrease in associated costs of treatment.

Leg Ulcers: Economic Aspects

2000 ◽  
Vol 15 (3-4) ◽  
pp. 110-114 ◽  
Author(s):  
O. Nelzèn
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Indirect Costs ◽  
Leg Ulcer ◽  
Cochrane Library ◽  
Western World ◽  
Leg Ulcers ◽  
Economic Analyses ◽  
The Cost ◽  
Chronic Leg Ulcers

Objective: To review what is known about the cost of leg ulcers, and venous leg ulcers in particular. Method: Searches of the Medline and Cochrane Library databases. Reviewing reference lists of personally gathered articles in the field of chronic leg ulcers. Synthesis: Most publications dealing with the economics of leg ulcers are cost studies assessing the cost of different dressings or bandages, and only a few have given estimates of the total costs of leg ulcer management. The latter, in conjunction with accurate epidemio-logical data, are essential to estimate the nationwide costs of leg ulcer management. The costs consist of direct and indirect costs for society. Direct costs are mainly staff costs for managing dressing-changes. Based on the few estimates made, approximately 1% of the total health care costs in the western world are likely to be used for management of chronic leg ulcers. To reduce the costs of leg ulcer management a reduction in the frequency of dressing-change is recommended. Improved use of high technology, such as duplex Doppler diagnostics and varicose vein surgery, is also likely to be cost-effective. On the basis of two health economic analyses leg ulcer clinics alone do not appear to reduce the costs of leg ulcer management, mainly because of an inability to prevent recurrent ulceration. Conclusion: The cost implications of chronic leg ulcers are insufficiently studied but there is no doubt that managing patients with leg ulcers takes a substantial proportion of the health care budget. More health economic analyses are needed to define the best treatment in order to reduce total costs.

Topical Human Growth Hormone Treatment of Chronic Leg Ulcers

1991 ◽  
Vol 6 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Lars H. Rasmussen ◽  
Tonny Karlsmark ◽  
Christian Avnstorp ◽  
Kurt Peters ◽  
Merethe Jørgensen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Placebo Group ◽  
Human Growth Hormone ◽  
Healing Rate ◽  
Controlled Trial ◽  
Human Growth ◽  
Leg Ulcers ◽  
Double Blind ◽  
Ulcer Area ◽  
Chronic Leg Ulcers

In a double-blind placebo-controlled trial, 37 patients with chronic leg ulceration were randomized to receive either topical human growth hormone, 1 IU cm −2 ulcer area, 5 d per week, or placebo, in addition to a standard treatment (compression, hydrocolloid dressing). The two groups were broadly similar in age, sex, initial ulcer area and underlying aetiological variables. During the study 18 patients were withdrawn (six in the growth hormone group and 12 in the placebo group; NS). Eight of them did not complete the 2 weeks of treatment necessary to establish a healing rate and were consequently not included in the analyses of healing. During a mean treatment period of 8 weeks, the healing rate was 16% per week (95% confidence interval 8.7 to 23% per week) in the growth hormone group and 3% per week (−3.4 to 8.4% per week) in the placebo group, ( P = 0.02). In 11 patients (61%) in the growth hormone group and two patients (18%) in the placebo group, the ulcer area decreased by 50% during the study ( P = 0.03). The treatment was neither accompanied by side-effects nor signs or symptoms indicating a significant absorption of growth hormone. Further studies are needed to address the dose-response relationship and optimal administration frequency of topical growth hormone in the treatment of chronic leg ulcers.

Causes and the way of treatment of patients with chronic leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (05) ◽  
pp. 211-218 ◽  
Author(s):  
C. Wax ◽  
A. Körber ◽  
J. Dissemond ◽  
J. Klode
Keyword(s):  
Treatment Period ◽  
General Practitioners ◽  
Peripheral Arterial Occlusive Disease ◽  
Mean Value ◽  
Arterial Occlusive Disease ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Patient Will ◽  
Peripheral Arterial ◽  
Chronic Leg Ulcers

SummaryChronic leg ulcer may have various causes, which are currently not centrally recorded in Germany. It is also unclear who treats patients with chronic leg ulcers in Germany and how the basic implementation of diagnosis and treatment of these patients looks like. Patients, methods: Therefore, we started a survey of 1000 general practitioners and practising specialists in dermatology, surgery and phlebology in five different regions of Germany. We carried out the genesis of a total of 6275 patients from 62 different practising therapists, 33 specialists in dermatology, surgery or phlebology and 29 general practitioners. Results: In 66.1% of all patients we found a venous leg ulcer, in 9.1% a leg ulcer from peripheral arterial occlusive disease, and in 8.5% a mixture of both. Thus there suffered a total of 83.8% of patients on chronic venous insufficiency or peripheral arterial occlusive disease as a major factor in the genesis of the chronic leg ulcer. However, even the rarely diagnosed entities such as exogenous factors, vasculitis, pyoderma gangrenosum or infectious diseases are occur in summation in 16.2% of all patients and should therefore be known and excluded. In addition, the treatment periods and referral routes of patients with chronic leg ulcer should be identified. The analysis showed that the vast majority (86.8%) of patients with chronic ulcers who were investigated by us is treated by specialists. The treatment duration of general practitioners is 6.3 weeks (mean value) before the patient will be referred to a specialist. This treatment period is significantly shorter compared to the treatment period of the specialists, who treat their patients 14.1 weeks (mean value) before the patient will be referred to another specialist or to a clinic. Conclusion: Our results show the current aspects of aetiology and the way of treatment of patients with chronic leg ulcers in Germany.

Ulcer osteoma and periosteal reactions to chronic leg ulcers.

1997 ◽  
Vol 168 (1) ◽  
pp. 155-157 ◽  
Author(s):  
D Karasick ◽  
M E Schweitzer ◽  
D M Deely
Keyword(s):  
Leg Ulcers ◽  
Chronic Leg Ulcers

Open-Label Study to Evaluate the Healing Rate and Safety of the Profore™ Extra Four-Layer Bandage System in Patients with Venous Leg Ulceration

2000 ◽  
Vol 4 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Aditya K. Gupta ◽  
Joel De Koven ◽  
Robert Lester ◽  
Neil H. Shear ◽  
Daniel N. Sauder
Keyword(s):  
Healing Rate ◽  
The Elderly ◽  
Leg Ulcers ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Venous Leg Ulcers ◽  
Initial Event ◽  
Venous Ulcers ◽  
High Compression

Background: Venous ulcers are increasing in prevalence, especially since these are observed more frequently in the elderly, and the number of individuals in this age group is becoming a larger portion of the population. Objective: To determine the healing rate and safety of the Profore™ Extra Four-Layer Bandage System in the management of venous leg ulcers. Methods: In an open-label study, patients aged 18 years or older with venous leg ulcers were treated with a high compression four-layer bandage system in which a hydrocellular dressing was placed in contact with the wound. The combination is designated the “Profore Extra Four-Layer Bandage System.” Follow-up visits took place weekly unless there was heavy exudation from the ulcer or if there was marked edema of the leg at the start of the study requiring reapplication of the bandage system. Results: Fifteen patients were entered into the study (men 8, women 7, mean age 66 years, mean duration of ulcers 1.3 years). Thirteen of the 15 patients completed the study, with two withdrawals. In one patient who withdrew, the ulcer became infected and required treatment with antibiotics. The other termination from the study occurred for reasons unrelated to treatment. The ulcer in this patient healed in 7 weeks. Ten of the 13 patients (77%) who completed the study, and 10 (67%) of 15, who had enrolled experienced complete (100%) healing. Healing of > 80% of the ulcers occurred in 11 of 13 patients (85%) who completed the study and in 12 (80%) of 15 enrolled patients. No patient experienced a study-related adverse event. One patient developed contact dermatitis and was later found to have stasis dermatitis. It is unclear whether the initial event was contact or stasis dermatitis. Conclusion: In this open-label study, a high compression system, using the Profore Extra Four-Layer Bandage with a hydrocellular dressing in contact with the wound, was found to be effective and safe for the treatment of venous leg ulcers.

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