Lothian and Forth Valley Leg Ulcer Healing Trial, Part 2: Knitted Viscose Dressing versus a Hydrocellular Dressing in the Treatment of Chronic Leg Ulceration

Author:

Callam M. J.1,Harper D. R.2,Dale J. J.3,Brown D.1,Gibson B.2,Prescott R. J.4,Ruckley C. V.1

Affiliation:

1. Vascular Surgery Unit, Royal Infirmary, Lauriston Place, Edinburgh

2. Department of Surgery, Falkirk and District Royal Infirmary

3. Lothian Health Board

4. Medical Statistics Unit, University of Edinburgh, UK

Abstract

Objective: To compare a new ‘advanced’ hydrocellular Polyurethane dressing (HPD) (Allevyn) with a traditional simple non-adherent knitted viscose dressing (KDV) (Tricotex) in the treatment of chronic venous leg ulcers. Design: A randomized trial of factorial design, with interaction testing, to allow the evaluation of two different therapeutic components (dressing and bandages) within a single trial. The treatment period was 12 weeks or until healing, whichever occurred sooner. Setting: The Leg Ulcer Clinics of Edinburgh and Falkirk and District Royal Infirmaries, Scotland. Patients: 132 patients with chronic venous leg ulcers were randomized, 66 to HPD and 66 to KVD. Principal exclusions were patients with diabetes, rheumatoid disease or Doppler ankle/brachial pressure indices of less than 0.8. There were 28 withdrawals (15 KVD, 13 HPD). These were considered as treatment failures. Interventions: Dressings and bandaging were applied by specialist leg ulcer nurses using standard techniques throughout, the bandaging being randomized to either elastic or non-elastic multilayer systems. Main outcome measure: The principal end-point was ulcer healing. Also monitored were healing rates, pain and the frequency of dressing changes. Results: Pain relief was significantly better in the HPD group ( p=0.01). Thirty-one (47%) of the HPD patients healed within 12 weeks compared with only 23 (35%) of the those treated with KVD (95% confidence limits for difference, −5% to +29%). The higest healing rates (61% for all ulcers and 74% for those less than 10 cm2) were observed in the subgroup in which HPD was used in combination with an elastic bandaging system. Conclusion: Patients treated with HPD did significantly better in terms of pain relief, although the higher healing rates observed in this group failed to reach significance at the 5% level.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine

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1. No More Venous Ulcers—What More Can We Do?;Journal of Clinical Medicine;2023-09-23

2. Compression bandages or stockings versus no compression for treating venous leg ulcers;Cochrane Database of Systematic Reviews;2021-07-26

3. Dressings and topical agents for treating venous leg ulcers;Cochrane Database of Systematic Reviews;2018-06-15

4. OUTCOME OF COMBINED SURGICAL TREATMENT IN CASE OF CHRONIC VENOUS LEG ULCER- A PROSPECTIVE STUDY;Journal of Evolution of Medical and Dental Sciences;2018-04-09

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