Do ready-made compression stockings fit the anatomy of the venous leg ulcer patient?

OBJECTIVE: How usable two standardised measuring methods are for the selection of three different brands of ready-made below-knee compression stockings. Furthermore, this study aims to determine how many of the included patients fit into a ready-made compression stocking in a limited selection of brands. METHOD: Consecutive patients suffering from venous insufficiency and treated at a specialised wound healing centre were included in this prospective comparative study. Two standardised measuring methods were used to evaluate the suitability of three different brands of ready-made below knee compression stockings. The circumference was measured at three points and seven points below the knee. The results of these measurements were compared to three selected brands of ready-made compression stockings. RESULTS: Together, 43 consecutive patients (25 men and 18 women) were included in the study. When the leg was measured at three points, 53.5%, 34.9% and 0% of the patients fitted into brand 1, brand 2 and brand 3 of the ready-made compression stockings, respectively. When measured at seven points, only 4.7% of the patients fitted into brand 1, 7% in brand 2 and 0% of the patients fitted into brand 3. CONCLUSION: These results demonstrate that there is a need to standardise measuring methods in the selection of ready-made below-knee compression stockings and a need for an evaluation of the present stocking sizes in relation to the anatomy of the venous leg ulcer patient. This study has shown that ready-made compression stockings presently prescribed will not properly fit the majority of patients to prevent oedema and ulcer recurrence. Further studies focused on the development of new sizes or changes in fitting recommendations may help solve these problems. DECLARATION OF INTEREST: There were no external sources of funding for this study. The authors have no conflicts of interest to declare with regard to the manuscript or its content.

Powder-free, non-sterile gloves assessed in a wound healing centre.

OBJECTIVE: To investigate the relative importance of features of gloves for medical staff working with problem wounds. DESIGN: Prospective, consecutive, crossover, open questionnaire investigation. SETTING: University hospital, Copenhagen, Denmark. SUBJECTS: 38 doctors, nurses, and podiatrists. INTERVENTIONS: Two types of powder-free, non-sterile gloves (No powder Ansell Medical and Skinsense Biogel coated examination glove) were evaluated in the outpatient clinic and the ward of the Copenhagen Wound Healing Center. MAIN OUTCOME MEASURES: Features of gloves regarded as important in the treatment of wounds and a comparison of the features based on the following criteria: much better = 2, better = 1, no difference = 0, worse = -1, much worse = -2. RESULTS: The first questionnaire showed that 84% of the respondents needed a new type of non-sterile glove, and for 66% the price of the glove was a main feature. The study of individual features of gloves showed that "protection" was ranked highest followed by "durability" and "sensitivity". Least important was the "length of the gloves" (p <0.01). The gloves were tested in two different time periods. The Skinsense Biogel glove was evaluated better or much better for "durability" (82%-92% (period 1, 2), p <0.001), "protection" (76%-80%, p <0.001) and "ease of donning" (68%-71%, p <0.001). The Ansell Medical glove was evaluated as better or much better for "tactile sensitivity" (77%-79%, p <0.001). The Skinsense Biogel glove showed more positive changes in skin condition than the Ansell Medical glove. The quality of packing of the Ansell Medical glove in the containers also resulted in more gloves being unusable when unpacked. CONCLUSION: The powder-free, non-sterile gloves were useful in a wound healing department. The Skinsense Biogel glove showed more advantageous features, less changes for the worse in the skin condition, and was better packed in the containers.

Long term therapy of pernicious anaemia with the depot cobalamin preparation betolvex.

The value of a depot cobalamin preparation Betolvex (cyanocobalamin-tannin complex suspended in a sesame-oil aluminum-monostearate gel) in the maintenance therapy of pernicious anaemia was investigated in 120 patients followed up for between 8 and 15 years. Complete haematological remission was maintained in all patients, and none developed B12 neuropathy after the start of treatment. No side-effects were observed. The mean values of S-cobalamin were above the reference limits when 1 mg cobalamin was given every 2 months, and high within the reference limits when given at 3 monthly intervals. The cobalamin content in the liver tissue in 2 patients who had received 1 mg cobalamin every 3 months for 6 years revealed normal values. Thus, 1 mg of the depot cobalamin preparation given at intervals of 3 months should provide adequate maintenance therapy in pernicious anaemia.