Here - EWMA 2013

POSTER: DIABETIC FOOT
Poster: Devices & Intervention
P 248
Results OF AN OBSERVATION STUDY ON THIRTEEN MIXED OR ARTERIAL LEG
ULCER PATIENTS WITH A NEW TWO-COMPONENT-SYSTEM (TCS)*
Martin Abel 1 , Sergio Mazzei 2 , Giovanni Mosti 3 , Agnes Collarte 4 , Valentina Dini 5 ,
Stefan Bahr 6 , Anna Coulborn 7 , Carsten Hampel-Kalthoff 8 , Christiane Zell 1 ,
Roberto Brambilla 2 , Hildegard Charles 4
1 Lohmann & Rauscher GmbH & Co KG (Rengsdorf, Germany);
2 Istituti Clinica Zucchi (Monza, Italy);
3
Private Out-patients Ambulance (Lucca, Italy);
4 Tissue Viability Department, Central London Community Healthcare NHS Trust, St
Charles Hospital (London, United Kingdom); 5 Private Out-patients Ambulance (La
Spezia, Italy); 6 TCW Therapiezentrum chronische Wunden Ortenau (Lahr, Germany);
7 The Wound Healing Centre WHC Eastbourne (Eastbourne, United Kingdom);
8 ORGAMED Dortmund GmbH (Dortmund, Germany).
Introduction: To compare the usability of an innovative new CE-marked short stretch
compression system, Two-Component-System (TCS)* on mixed (MLU) or arterial leg
ulcer (ALU) patients in comparison to venous leg ulcer (VLU) patients a sub-analysis of
an observation study was conducted.
Material & Methods: In a multicentre (7), international post marketing surveillance study
(PMS) on 102 leg ulcer patients with or without oedema treated with TCS* over 2 weeks
the usability of the compression system could be proven. Thirteen (12.75%) of these
patients (13/102) were diagnosed with non-infected mixed or arterial leg ulcers with an
ankle brachial index (ABPI) generally measured between 0.5 and 0.9. The application of
the set was applied according to the instructions of use (compression bandage full
stretch/safe lock) and under supervision of the responsible physician.
Results: For MLU or ALU patients the TCS* showed in the general assessment
(slippage, rolling, loss of sensitivity, feeling of tightness, of heat, itching, exudate in the
bandage) very good results – total mean** 0.3 = ‘low’ to ‘nothing’. Equally very good
results has been observed for in the technical assessment of TCS* (easy to use,
movement of the ankle was sufficient, very thin – no problems for shoes, comfortable),
the quality of life evaluation (feeling of well-being in general, during night or day, social
life conditions, the working ability, joy of life, wearing comfort and very thin) and the
potential for oedema reduction rated with a total mean* of 1.5 to 2.0 = ‘very good’. Skin
alterations were very rare. The results are comparable to the results of VLU patients.
Conclusions: TCS* is very tolerable, safe and comfortable for treating all leg ulcers –
also mixed or arterial ulcers (under supervision of the responsible physician) – with or
without oedema.
*Rosidal ® TCS, Lohmann & Rauscher. **median
P 249
ASSESSING CHRONIC DIABETIC FOOT WOUNDS FOR EPA (ELEVATED
PROTEASE ACTIVITY)
Poster: Diabetic Foot
Paul Chadwick 1
1 Salford Royal (NHS) Foundation Trust (Salford, United Kingdom).
Aim: The primary objective was to evaluate the clinical benefits of using a new protease
activity test* capable of assessing protease activity directly from wound fluid. It is
designed to help clinicians establish within minutes which wounds may most benefit from
a protease modulating therapy, thus ensuring appropriate and targeted use of these
therapies.
Methods: 15 chronic diabetic foot ulcers from a convenience sample of patients
attending a multi-disciplinary foot clinic, was assessed using the new protease test. Data
was collected on wound age, prior treatment, and the percentage of ‘elevated’ test
results and clinicians were asked to rate several elements regarding the practicalities of
the test using a likert scale.
Results: EPA prevalence for the test group was 33%. The mean scores for:-
• Ease of use of the test was 4.6 out of 5
• Degree to which the test improved wound assessment – 4.3.
• Degree of improvement in confidence in treatment choice – 4.3.
• Degree to which the test offered the ability to allocate advanced therapies more
effectively – 4.6.
One particular case demonstrated that detecting EPA and treating with a protease
modulator the wound significantly reduced in size and was now on a healing trajectory
within 3 weeks.
Conclusions: Protease testing enables clinicians to target therapies more effectively.
Clinical and budgetary benefits can only be maximised on if diagnostic tools are used as
part of an integrated, structured approach to patient management.
*WOUNDCHEK Protease Status
**PROMOGRAN PRISMA ®
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
153