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fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Publisher: Elsevier
Languages: English
Types: Article
Subjects:
This study was to evaluate the potential benefits of two products (Oxyzyme® & Iodozyme®) into a leg ulcer service in South Staffordshire, UK. \ud A randomised controlled Trial (RCT) was used to evaluate time to ulcer healing, quality of life, pain and cost effectiveness. \ud 100 patients were randomised to receive either Oxyzyme/ Iodozyme (active group) or standard care (control group) with venous or mixed arterio-venous ulcers. Patients were evaluated weekly up to 12 weeks, with further follow up at 24 weeks. Whilst there was a small benefit in terms of healing over follow up using the Cox Proportional Hazards Model, this did not achieve a standard level of statistical significance (Hazard Ratio= 1.13, 95%CI 0.64 to 2.02, p=0.67) after adjustment for confounding factors. Patients with high protease activity showed an improved and faster healing in the active group, (HR=1.35, 95%CI 0.63, 2.87)p=0.44. \ud The active group required significantly fewer dressing changes (14.8 versus 10.0, p=0.033). Despite the dressing costs being higher, there was a significantly lower cost of nursing time, leading to a greater cost effectiveness in terms of cost per healed ulcer (£977 versus £1071. A Markov model used to assess cost effectiveness in the main trial found that the control group had slightly better outcomes (12 more ulcer free weeks), but at a substantially greater cost (£5,031). When those with high protease activity the cost in the active group dominated, with lower cost (-£2,450) and an improved outcome (29 more ulcer free weeks). \ud Health related quality of life (HRQoL) and pain significantly improved over the assessment period, though there was no difference between the treatment groups. \ud The use of Oxyzyme® & Iodozyme®) could provide better value for money in the management of venous and mixed arterio-venous ulcers than standard care in a community leg ulcer service.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1.Moffatt CJ, Franks PJ, Doherty DC, Martin R, Blewett R, Ross F Prevalence of leg ulceration: a study in a London population. QJM 2004; 97(7): 431-437 3.Cullum N, Nelson EA, Fletcher AW, Sheldon TA.
    • http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000265.pub3 4.Moffatt CJ (2003), Understanding compression therapy. In EWMA Position Document. Understanding compression therapy. London. Medical Education Partnership.
    • 11. Curtis L. Unit costs of Health & Social Care 2011. Personal Social Services Research Unit, University of Kent. 2011 12. Brimson CH, Nigam Y The role of oxygen-associated therapies for the healing of chronic wounds, particularly in patients with diabetes. Journal of the European Academy of Dermatology and Venereology 2013; 27: 411-418 13.Ivins N, Simmonds W, Turner A, Harding K. The use of an oxygenating hydrogel dressing in VLU. Wounds UK 2007; 3(1) 77-81 14. Queen D, Coutts P, Fierheller M, Sibbald RG. The Use of a Novel Oxygenating Hydrogel Dressing in the Treatment of Different Chronic Wounds Advancs in Skin and Wound Care 2007; 20(4) 200-206 15.Davis P, Wood L Wood Z, Eaton A, Wilkins J. Clinical experience with a glucose oxidase-containing dressing on recalcitrant wounds. Journal of Wound Care 2009; 18(3) 114-121 16. Franks PJ, Bosanquet N, Brown D, Straub J, Harper DR, Ruckley CV.
    • Eur. J. Vasc. Endovasc. Surg. 1999; 17 (2): 155-159
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