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Observations of Periwound Skin Protection in Venous Ulcers: A Comparison of Treatments

Hunter, Susan M. MSN, RN; Langemo, Diane PhD, RN, FAAN; Thompson, Patricia MS, RN; Hanson, Darlene MS, RN; Anderson, Julie PhD, RN; Oh, In Eui BSN, RN; Paulson, Rolf MD, FACP; Rustvang, Dan CWS, FNP; Dorman, Seth CWS, FNP; Roth, David L. PhD

doi: 10.1097/01.ASW.0000426714.57540.c4

OBJECTIVE: The objective of this study was to examine the effectiveness of 2 products on venous ulcer periwound skin.

DESIGN: This was a descriptive comparative study.

SETTING: An outpatient wound care clinic in a rural Midwestern area of the United States.

PARTICIPANTS: Participants included a retrospective group of 50 patients and a prospective group of 28 patients.

INTERVENTION: The intervention compared the experimental product (Remedy Nutrashield; Medline Industries, Mundelein, Illinois) versus Cavilon Moisturizing Lotion (3M, St Paul, Minnesota).

OUTCOME MEASURES: The mean outcome measures were a decrease in periwound and ulcer size.

MAIN RESULTS: For the periwound size, the estimated rates of change were as follows: 0.092 (SE, 0.021) cm/d and −0.026 (SE, 0.014) cm/d for products B and A groups, respectively. The decrease for the experimental group was significantly greater than the attenuated decrease for the retrospective cases (t297 = −2.57, P = .01), and the decrease for product B group was also significantly different from zero (t76 = −4.34, P < .0001). For the ulcer size model, the estimated rates of change were −0.272 (SE, 0.102) cm2/d and −0.130 (SE, 0.067) cm2/d for the experimental and retrospective groups, respectively. The rate for the experimental group was significantly less than zero (t76 = −2.67, P = .009), but there was no significant difference between prospective and retrospective cases in the rates of reduction in ulcer size (t308 = −1.16, P = .25).

CONCLUSION: The results of this study illustrate how the integrity of the periwound skin may be an important determinant in decreasing periwound and ulcer size.

The authors examine the effectiveness of 2 products on venous ulcer periwound skin.

Susan M. Hunter, MSN, RN, is Associate Professor;

Diane Langemo, PhD, RN, FAAN, is Adjunct Faculty;

Patricia Thompson, MS, RN, is Associate Professor;

Darlene Hanson, MS, RN, is Clinical Associate Professor;

Julie Anderson, PhD, RN, is Associate Professor; and

In Eui Oh, BSN, RN, is Graduate Research Assistant, all at the University of North Dakota College of Nursing, Grand Forks, North Dakota.

Rolf Paulson, MD, FACP, is Medical Director of the Altru Vascular Center and Chronic Wound Clinic;

Dan Rustvang, CWS, FNP, is Nurse Practitioner; and

Seth Dorman, CWS, FNP, is Nurse Practitioner, all at the Altru Chronic Wound Clinic, Grand Forks, North Dakota.

David L. Roth, PhD, is Director, Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.

Ms Hunter disclosed that Medline provided travel expenses for this research to be presented as a poster at the Clinical Symposium on Advances in Skin & Wound Care, September 9–12, 2011, National Harbor, Maryland. Dr Langemo, Ms Thompson, Ms Hanson, Dr Anderson, Ms Oh, Dr Paulson, Mr Rustvang, Mr Dorman, and Dr Roth have disclosed they have no financial relationships related to this article.

The authors disclose that this research was supported by Medline Industries.

Acknowledgment: The authors thank the staff at the clinic research center and the wound clinic for their assistance with this study.

Submitted May 11, 2012; accepted in revised form August 7, 2012.

© 2013 Lippincott Williams & Wilkins, Inc.