potassium-permanganate and Leg-Ulcer

Twenty-six elderly patients with chronic leg ulcers infected by Pseudomonas aeruginosa or other aerobic Gram-negative rods were randomised to two treatment groups. The control group (eight patients) received conventional local therapy and the other group (18 patients) was treated with oral ciprofloxacin for three months in addition to conventional local therapy. In the beginning of the study both groups were comparable with the age of the patients and the associated diseases including impairment of arterial and venous circulation in the lower legs. Also the size, duration and the severity of the inflammation reaction in the leg ulcers were comparable before the start of the therapy. Ciprofloxacin was clinically more effective than the standard therapy in reducing the size of the ulcer (p less than 0.05). Also the need of extra systemic antibiotics decreased significantly in the ciprofloxacin group compared with the controls. In three out of eighteen ciprofloxacin treated patients the leg ulcers disappeared completely during the three months' study period compared with none in the control group. However, ciprofloxacin resistant strains, mainly staphylococci, appeared in the leg ulcers in 67% of the ciprofloxacin treated patients compared with 0% in the control group (p less than 0.01). No significant side-effects due to ciprofloxacin except the resistant strains were noticed. We conclude that oral long-term ciprofloxacin therapy is effective in the treatment of chronic leg ulcer infections due to Gram-negative rods but selection of ciprofloxacin resistant strains is a problem in this patient group.

Topics: Administration, Oral; Aged; Bacterial Infections; Chlorhexidine; Ciprofloxacin; Disinfectants; Drug Evaluation; Drug Resistance, Microbial; Female; Gram-Negative Bacteria; Humans; Leg Ulcer; Male; Microbial Collagenase; Potassium Permanganate; Pseudomonas Infections; Random Allocation; Streptodornase and Streptokinase

Fusarium spp. are fungi found throughout the world and can cause a great variety of skin infections, mainly in immunodepressed individuals. We present a case of skin infection with Fusarium sp. which manifested as painful superficial ulcers on the legs of an immunocompetent female patient, who had applied <> as a <> for leg pain. The condition was cured with oral itraconazole and local treatments.

Topics: Aged; Antifungal Agents; Dermatomycoses; Drug Therapy, Combination; Female; Fusarium; Humans; Immunocompetence; Itraconazole; Ketoconazole; Leg Ulcer; Mud Therapy; Potassium Permanganate; Soil Microbiology; Venous Insufficiency

Very little research has explored patients' experience of pain with different cleansing agents and dressings. We therefore undertook a longitudinal study of their impact on leg ulcer pain.. Patients with leg ulcers referred to community nurses were eligible to participate. They were followed up for six months, completing questionnaires about the impact on pain of each wound treatment used. A treatment episode was defined as the use of a wound cleansing agent, primary dressing and bandages. When one aspect of treatment changed, a new treatment episode began.. There were 210 treatment episodes for 96 leg ulcer patients. In 206 episodes cleansing agents were used. Cleansing caused pain in 22% of episodes and relieved pain in 27%. Of the five most commonly used dressing types, low-adherent dressings were the least likely to cause pain. Only 56% of patients were able to tolerate full compression bandaging and pain was the most common reason for non-compliance.. A substantial proportion of patients felt that leg ulcer treatments caused pain. A greater emphasis on the impact of treatment on pain and healing is warranted both clinically and in research.

Topics: Aged; Aged, 80 and over; Anti-Infective Agents, Local; Attitude to Health; Bandages; Choice Behavior; Emollients; Female; Humans; Leg Ulcer; Longitudinal Studies; Male; Middle Aged; Nursing Methodology Research; Pain; Pain Measurement; Potassium Permanganate; Risk Factors; Skin Care; Sodium Chloride; Surveys and Questionnaires; Therapeutic Irrigation; Triclosan; Wound Healing

Topics: Animals; Bandages; Humans; Leg Ulcer; Porifera; Potassium Permanganate; Ulcer