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The Effectiveness of EMLA as a Primary Dressing on Painful Chronic Leg Ulcers: A Pilot Randomized Controlled Trial

Purcell, Anne MNurs (Nurs Prac), RN, NP; Buckley, Thomas PhD, RN; Fethney, Judith BA; King, Jennie PhD, RN; Moyle, Wendy PhD, RN; Marshall, Andrea P. PhD, RN

doi: 10.1097/01.ASW.0000516197.13492.1a
Features: Original Investigations

OBJECTIVE: To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers.

DESIGN: A pilot randomized controlled trial.

SETTING: The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia.

PARTICIPANTS: Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study.

INTERVENTION: Participants were randomly assigned to an intervention (daily EMLA use for 4 weeks as a primary dressing) or a standard wound care group.

MAIN OUTCOME MEASURE: The effectiveness of EMLA on wound-related pain intensity before, during, and after dressing change.

MAIN RESULTS: Mean pain scores were similar between the 2 groups at baseline (P = .84). During dressing change, mean pain scores across the 4-week intervention period were significantly lower in the intervention compared with the control group (intervention group: mean, 3.39 [SD, 2.16]; control group: mean, 4.82 [SD, 2.27]; P = .02). Mean pain scores after dressing change were also significantly lower for the intervention group over the 4-week intervention period (intervention group: mean, 2.71 [SD, 1.94]; control group: mean, 3.92 [SD, 2.03]; P = .03).

CONCLUSIONS: Data from this pilot study suggest that EMLA as a primary dressing may be effective in reducing chronic leg ulcer pain during and after dressing change and warrant further evaluation.

Anne Purcell, MNurs (Nurs Prac), RN, NP, is a Nurse Practitioner, Wound Management, Coast Local Health District, Gosford, New South Wales, and Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia. Thomas Buckley, PhD, RN, is an Associate Professor, Nursing; and Judith Fethney, BA, is a Biostatistician, Sydney Nursing School, The University of Sydney, Camperdown, New South Wales, Australia. Jennie King, PhD, RN, is a Clinical Nurse Consultant, Research, Central Coast Local Health District, Gosford, New South Wales, and Sydney Nursing School, The University of Sydney, Camperdown, New South Wales, Australia. Wendy Moyle, PhD, RN, is a Professor, Director of the Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia. Andrea P. Marshall, PhD, RN, is Professor of Acute and Complex Care Nursing, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, and Gold Coast Health, Southport, Queensland, Australia. The authors have disclosed that they have no financial relationships related to this article and that they will discuss the off-label use of EMLA as a primary dressing on painful chronic lower leg ulcers. Acknowledgments: This study was financially supported by the New South Wales Health Nursing and Midwifery Innovation Scholarship; the Australian Wound Management Research Foundation; and the Central Coast Health Research Advisory Committee CHARM Research Grant. The authors thank the participants and their families for their commitment to this study, the CCLHD Community Nursing Service, and Donald Sutherland and Jonathan Brinton, research assistants, for their contribution to recruitment and data collection. The authors also thank Wendy White, Director, Educator, Wendy White Wound Care, for her role as clinical advisor to the study. Submitted February 4, 2016; accepted in revised form May 10, 2016.

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