June, 2005

Dear Readers,

While it is well known and accepted that appropriate compression is key to managing venous leg ulcers, the application of compression bandages requires a caregiver skilled in their use. In the Evidence Corner, Dr. Laura Bolton reviews 2 papers reporting clinical outcomes using tubular bandages, which require less experience and skill for application. The results reported in both studies showed that healing of venous ulcers was comparable in patients treated with moderate to high compression delivered by bandages, stockings, or tubular compression devices. Given these outcomes data, it would appear that many venous ulcer patients could benefit from the use of tubular dressings.

Dobke et al. (A novel approach to an acute infection of glenohumeral joint following rotator cuff repair—a case series) present their results using negative pressure wound therapy (NPWT) following debridement and drainage for treating a post-surgical infection of the glenohumeral joint. The course of treatment in the case series is detailed, and the results indicate that NPWT was a useful adjunct in managing this condition.

Hardikar et al. (Efficacy of recombinant human platelet-derived growth factor [rhPDGF] based gel in diabetic foot ulcers: a randomized, multicenter, double-blind, placebo-controlled study in India) report results from a well-designed study showing the effects of PDGF on the healing of diabetic foot ulcers (DFUs). The primary efficacy endpoint was wound closure with complete epithelization and no drainage or eschar. At both 10 weeks and 20 weeks, the PDGF-treated patients showed significantly better healing than the placebo group (71% versus 31% and 85% versus 53% achieving the primary endpoint). Average time to healing was also shorter in the PDGF treatment group. The results of this trial show greater efficacy than previously published studies of PDGF in the treatment of DFUs. The authors discuss some of the variables in the present study that may account for these differences.

Dermal substitutes that were developed primarily for the treatment of burn wounds have been reported to be useful in many situations requiring reconstructive surgery. Lakshman et al. (Case report: the use of dermal substitute in the reconstruction of full-thickness burns to the penis) discuss the treatment of a rare and unusual case of full-thickness burns to the dorsum of the penis. The authors found that use of a dermal substitute was a viable option for reconstruction, leading to excellent cosmetic and functional results in this potentially devastating injury.