Does the use of compression bandaging as an adjunct improve outcomes for people following excision of keratinocyte cancers of the lower leg with secondary intention healing?

Mann, Jennifer E.; Ashraf, Iqra; McGinnis, Elizabeth; Veitch, David; Wernham, Aaron

doi:10.1111/ced.15103

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…A previous survey 8 of 312 members of the British Society for Dermatological Surgeons (BSDS) showed that 56% of the 109 respondents used compression postsurgery; however, supporting evidence for compression use is underdeveloped. A comprehensive literature search 9 did not reveal any randomized controlled trials (RCTs) on the use of compression following cutaneous surgery on the lower leg. Suitable data on healing rates in this patient group are not available to inform either clinicians, patients or RCT design.…”

Section: Introductionmentioning

confidence: 99%

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 1: a multicentre prospective observational cohort study in patients without planned compression

Pynn

Ransom

Walker

et al. 2022

Clinical and Experimental Dermatology

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Background. There is no agreed treatment pathway following excision of keratinocyte cancer (KC). Compression therapy is considered beneficial for secondary intention healing on the lower leg; however, there is a lack of supportive evidence. To plan a randomized controlled trial (RCT), suitable data are needed. We report a multicentre prospective observational cohort study in this patient population with the intention of informing a future trial design. Aim. To estimate the time to healing in wounds healing by secondary intention without planned postoperative compression, following excision of KC on the lower leg; to characterize the patient population, including factors affecting healing; and to assess the incidence of complications. Methods. This was a multicentre prospective observational cohort study. Inclusion criteria were age ≥ 18 years with planned excision of KC on the lower leg and healing by secondary intention, an ankle-brachial pressure index (ABPI) of ≥ 0.8; and written informed consent. Exclusion criteria included planned excision with primary closure, skin graft or flap; compression therapy for another indication; planned compression; inability of patient to receive, comply with or tolerate high compression; or a suspected diagnosis other than KC.Results. This study recruited 58 patients from 9 secondary care dermatology clinics. In the analysis population (n = 53), mean age was 81 years (range 25-97 years), median time to healing was 81 days (95% CI 73-92) and 45 patients (84.9%) had healing of the wound at the 6-month follow-up. The healing prognostic factors were wound parameters and ABPI. Wound infections occurred in 16 participants (30.2%). Four patients (7.5%) were admitted to hospital; three because of an infection and one because of a fall.

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Section: Introductionmentioning

confidence: 99%

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 1: a multicentre prospective observational cohort study in patients without planned compression

Pynn

Ransom

Walker

et al. 2022

Clinical and Experimental Dermatology

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“…For many keratinocyte cancers (KC) on the lower leg treated by excision, the wounds are left to heal by secondary intention. However, there is a paucity of research on effectiveness of interventions for secondary intention wound healing following cutaneous surgery, 1 and there are no standardized methods for the treatment of secondary intention surgical wounds on the lower leg.…”

Section: Introductionmentioning

confidence: 99%

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 2: feasibility data from a multicentre prospective observational cohort study to inform a future randomized controlled trial

Gilberts

McGinnis

Ransom

et al. 2022

Clinical and Experimental Dermatology

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Background. Compression therapy is considered beneficial for postsurgical lower leg wound healing by secondary intention; however, there is a lack of supportive evidence. To plan a randomized controlled trial (RCT), suitable data are needed. Aim. To determine the feasibility of recruitment and estimate recruitment rate; to understand the standard postoperative wound management pathway; to determine uptake of optional additional clinic visits for healing confirmation; and to explore patient acceptability of compression bandaging and plan a future RCT. Methods. Participant recruitment was performed from secondary care dermatology clinics, during a period of 22 months. Inclusion criteria were age ≥ 18 years, planned excision of keratinocyte cancer on the lower leg with healing by secondary intention and an ankle-brachial pressure index of ≥ 0.8. Exclusion criteria were planned primary closure/graft or flap; inability to receive, comply with or tolerate high compression; planned compression; or suspected melanoma. Patients were followed up weekly (maximum 6 months) in secondary care clinics and/or by telephone. Information was collected on healthcare resource use, unplanned compression, wound healing and an optional clinic visit to confirm healing. Results. This study recruited 58 patients from 9 secondary care dermatology clinics over 22 months. Mean recruitment/centre/month was 0.8 (range 0.1-2.3). Four centres had dedicated Research Nurse support. The analysis population (n = 53) had weekly follow-up assessments. Standard care clinical contacts were: general practitioner (7 visits; 1.2%), community nurse (169; 28.5%), practice nurse visits (189; 31.8%) and dermatology clinic visits (138; 23.2%). Participants whose wounds healed (34 of 45; 75.6%) attended an optional clinic visit. Conclusion. Data were obtained to inform a future RCT. Recruitment rates were found to be higher in centres with dedicated research support. People

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Cuidado de la herida quirúrgica tras cirugía dermatológica. Una actualización y revisión narrativa

Sanchez-Puigdollers,

Toll,

Morgado-Carrasco

2024

Actas Dermo-Sifiliográficas

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Does the use of compression bandaging as an adjunct improve outcomes for people following excision of keratinocyte cancers of the lower leg with secondary intention healing?

Cited by 4 publications

References 4 publications

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 1: a multicentre prospective observational cohort study in patients without planned compression

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 1: a multicentre prospective observational cohort study in patients without planned compression

Healing of ExcisionAl wounds on Lower legs by Secondary intention (HEALS) cohort study. Part 2: feasibility data from a multicentre prospective observational cohort study to inform a future randomized controlled trial

Cuidado de la herida quirúrgica tras cirugía dermatológica. Una actualización y revisión narrativa

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