Comparison of cadexomer iodine and dextranomer for chronic venous ulcers

Abstract

Summary Forty‐two patients with chronic resistant varicose ulcers were observed for 6 weeks on standard out‐patient therapy, and then randomly allocated to daily treatment with either cadexomer iodine (CI), a new topical agent, or dextranomer for a further 6 weeks, at which time ulcers judged clinically not to be responding could be changed to the other treatment for the remaining 20 weeks of the trial. There was no significant reduction in ulcer area during the first 6 weeks on CI or dextranomer. A significant preference for CI was shown by the optional crossover. Retrospective analysis of ulcer size shows this was not related to severity and preference was probably due to bias towards the new treatment, the trial not being blind. Neither therapy significantly reduced colonization by β‐haemolytic Streptococcus, Staphytocoaus aureus, Pseudomonas or Proteus. The discrepancy between these and previous findings with CI is largely due to different methods of analysis rather than different results. We conclude that, in chronic resistant venous ulcers, topical therapy is of little importance compared with measures which improve tissue oxygenation and repair.

Topical iodophor use in chronic wounds: a literature review

“…in another study (11) , Comparing CI with other conventional treatments, the authors (13) achieved similar results to those found in previous studies (9)(10)(11) , with no significant difference between the groups regarding the reduction of venous ulcer area sizes. However, a significant reduction of pain was found during the first weeks of treatment with CI.…”

“…In addition, in some of them, different products were used for cleansing or for the maintenance of the wound (12,(20)(21) , which could cause interaction with the topical products used previously or afterwards, or yet distinct influence on the healing process. On the other hand, half the clinical trials did not describe the randomization process for the composition of treatment groups (10)(11)(12)14,(18)(19)(20) . It is also important to consider the restricted size of the sample in the studies analyzed.…”

A randomized‐controlled trial comparing cadexomer iodine and nanocrystalline silver on the healing of leg ulcers

“…There have been a small number of studies that did not support the use of cadexomer iodine. Cadexomer iodine did not result in superior healing when compared with gentamicin solution, streptodornase/streptokinase, or dry saline gauze for diabetic foot wounds 26 and dextranomer beads 27 . Both studies involved small sample sizes, between 17 and 42 participants, respectively, and the latter involved a short follow‐up period of 6 weeks.…”

The debridement of chronic wounds: a systematic review.

“…Methods assessment of quantitative planimetric results indicated that there was no difference between the two treatments. 13 This appears to be a characteristic feature of research in this area; subjective measurements almost invariably overestimate the relative effectiveness of the experimental treatment compared with objective measures in the same trial.…”

“…Three RCTs were included that compared cadexomer iodine polysaccharide with another debriding agent ( Figure 5; appendix 6, Table 10 ). Dextranomer polysaccharide 13,54 was the comparator in two trials and a hydrogel was used in the third trial. 55 None of the trials showed a statistically significant effect, and in two the point estimate of relative effectiveness was close to the line of no effect.…”