Thirty-four patients with decubitus ulcers were studied in a randomized trial to compare topical cadexomer iodine with the standard decubitus ulcer treatments used in the participating hospitals. There was a significant reduction of ulcer area with both treatments within three weeks; however, eight of 16 patients treated with cadexomer iodine had a reduction of ulcer area of more than 50 per cent, compared with one of 18 patients treated with the standard treatment (P less than 0.01). Twenty-seven patients continued the same treatment for five more weeks, during which time six in the cadexomer iodine group healed, compared with one in the standard treatment group (P less than 0.05). Cadexomer iodine was superior to the standard treatment in removing pus and debris from the ulcer surface and in reducing pain at the ulcer site. It was found to be easy both to apply and to remove from the ulcers and did not stain skin or clothing. Transient smarting during the first hour after application was reported by three patients, and one patient complained of skin irritation. The results show that cadexomer iodine applied daily has a debriding effect on decubitus ulcers and accelerates healing.

We studied the effect of omeprazole, a benzimidazole inhibitor of gastric acid secretion, in patients with Zollinger-Ellison syndrome. In five patients ingestion of 80 mg of omeprazole inhibited gastric acid secretion by 26 to 100 per cent after 6 hours and by 76 to 100 per cent after 24 hours. Seven patients were continuously treated with omeprazole once or twice daily for 8 to 19 months (average, 14). Six of these seven had symptoms that were resistant to high doses of histamine H2-receptor antagonists, and the seventh could not take high doses of cimetidine because of a possible drug-related increase in the serum creatinine concentration. Symptoms resolved in all patients within two weeks, and peptic lesions were healed at endoscopy after four weeks. All patients remained free of symptoms, and gastric acid secretion continued to be markedly inhibited by omeprazole therapy. We conclude that omeprazole is a potent and long-acting antisecretory drug in patients with Zollinger-Ellison syndrome and that it is effective in patients whose peptic-ulcer disease is relatively resistant to treatment with histamine H2-receptor antagonists. Its safety and effectiveness in long-term therapy remain to be assessed.

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