The aim of the study was to evaluate a possible influence of selected bacterial species on healing of venous leg ulcers. Fifty-nine patients with venous leg ulcers were followed via frequent semiquantitative culture of bacteria from the ulcer surface and determination of the ulcer area over a period of 180 days. Occurrences of cellulitis were treated with systemic antibiotics. There was a significant difference in relative areas on days 90 and 180 when ulcers with growth of Pseudoomonus ueruginosu were compared to those without (p=0.0080 and 0.0133, respectively). Ulcers with P. ueruginosa were characterized to a great extent by enlargement in contrast to those without. Ulcers with growth of Stuphyiococcus uureus or haemolytic streptococci healed significantly more slowly than those without when relative areas were compared on day 180 (p=0.0079 and 0.0492, respectively). Complete healing within the observation period of 180 days was observed in 10.5'%~ of patients with P. aeruginosa and 35% of those without (p=0.0631), in 21.6% of patients with S. uureus and 62.5% of those without (p=0.0278), and in 10.5'%, of patients with haemolytic streptococci and 35% of those without ( p = 0.0631). The initial areas of ulcers colonized with P. aeruginosu or S. uureus were significantly larger than those without, but no significant correlation between initial areas and ulcer healing was revealed. Conclusion: Our results suggest that P. aeruginosa in venous leg ulcers can induce ulcer enlargement and/or cause a healing delay. The results also suggest a healing delay caused by S. uureus and haemolytic streptococci. However, conclusions have to be treated with caution since P. ueruginosu was found in combination with haemolytic streptococci in 15.3% of the patients.

No abstract

No abstract

The clinical and bacteriological efficacy of topical cadexomer iodine on venous leg ulcers colonised with Pseudomonas aeruginosa was evaluated in an open, uncontrolled, multicentre pilot study. Nineteen patients with venous leg ulcers (median ulcer area 15.5cm2) were treated with cadexomer iodine paste and short-stretch bandaging for 12 weeks or until the ulcer was healed within that period. Bacteriological cultures for growth of Pseudomonas aeruginosa and ulcer area measurements were regularly performed during the study period. Seven patients were withdrawn during the study period for the following reasons: pain in the ulcer (n=2), ulcer enlargement (n=2), treatment of cellulitis in non-study ulcer with a systemic antibiotic that is effective against Pseudomonas aeruginosa (n=1), increased thyroid-stimulating hormone level (n=1) and poor compliance (n=1). In addition, one patient was erroneously withdrawn. After one week's treatment, 11 out of 17 patients (65%) had a negative culture of Pseudomonas aeruginosa. At 12 weeks, six out of eight patients (75%) had a negative culture and complete healing was achieved in three patients (16%). The median ulcer area reduction obtained at 12 weeks was 32.9%. The results indicate that cadexomer iodine paste might be the treatment of choice for venous leg ulcers colonised with Pseudomonas aeruginosa. However, a larger controlled clinical study is needed for final evaluation.

No abstract