Observations of periwound skin protection in venous ulcers: A comparison of treatments

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). OUTCOMME 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.