Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic oedema: a randomised controlled trial protocol

被引:7
作者
Webb, Elizabeth [1 ,2 ]
Neeman, Teresa [3 ]
Gaida, Jamie [4 ]
Bowden, Francis J. [5 ,6 ]
Mumford, Virginia [7 ]
Bissett, Bernie [2 ]
机构
[1] Calvary Publ Hosp Bruce, Dept Physiotherapy, Canberra, ACT, Australia
[2] Univ Canberra, Fac Hlth, Discipline Physiotherapy, Canberra, ACT, Australia
[3] Australian Natl Univ, Biol Data Sci Inst, Canberra, ACT, Australia
[4] Univ Canberra, UC RISE, Canberra, ACT, Australia
[5] Calvary Publ Hosp Bruce, Canberra, ACT, Australia
[6] Australian Natl Univ, Med Sch, Canberra, ACT, Australia
[7] Macquarie Univ, Australian Inst Hlth Innovat, Sydney, NSW, Australia
关键词
infectious diseases; cellulitis; recurrence; lymphedema; edema; compression stockings; ERYSIPELAS; LEG; MANAGEMENT; LYMPHEDEMA; VALIDITY; PEROMETRY; COSTS;
D O I
10.1136/bmjopen-2019-029225
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Cellulitis represents a significant burden to patients' quality of life (QOL) and cost to the healthcare system, especially due to its recurrent nature. Chronic oedema is a strong risk factor for both an initial episode of cellulitis and cellulitis recurrence. Expert consensus advises compression therapy to prevent cellulitis recurrence in individuals with chronic oedema, however, there is little supporting evidence. This research aims to determine if the management of chronic oedema using compression therapy effectively delays the recurrence of lower limb cellulitis. Methods and analysis A randomised controlled trial with cross-over will be used to assess the impact of compression therapy on clinical outcomes (time to next episode of cellulitis, rate of cellulitis-related hospital presentations, QOL and leg volume). Using concealed allocation, 162 participants will be randomised into the intervention (compression) or control (no compression) group. Randomisation will be stratified by prophylactic antibiotic use. Participants will be followed up at 6 monthly intervals for up to 3 years or until 45 episodes of cellulitis occur across the cohort. Following an episode of recurrent cellulitis, control group participants will cross-over to the intervention group. Survival analysis will be undertaken to assess the primary outcome measure of time to cellulitis recurrence. The hypotheses are that compression therapy to control lower limb chronic oedema will delay recurrent lower limb cellulitis, reduce the rate of associated hospitalisations, minimise affected limb volume and improve the QOL of this population. Ethics and dissemination Ethics approval has been obtained from the ethics committees of all relevant institutions. Results will be disseminated through relevant peer-reviewed journal articles and conference presentations. Trial registration number ACTRN12617000412336; Pre-results. The ICTOC trial is currently in progress. Participant recruitment started in May 2017 and is expected to continue until December 2019.
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页数:8
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共 36 条
[21]   The validity and reliability of the Perometer in evaluating human knee volume [J].
Man, IOW ;
Markland, KL ;
Morrissey, MC .
CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, 2004, 24 (06) :352-358
[22]   The Concept of Chronic Edema-A Neglected Public Health Issue and an International Response: The LIMPRINT Study [J].
Moffatt, Christine ;
Keeley, Vaughan ;
Quere, Isabelle .
LYMPHATIC RESEARCH AND BIOLOGY, 2019, 17 (02) :121-126
[23]   Chronic peripheral oedema: the critical role of the lymphatic system [J].
Mortimer, PS ;
Levick, JR .
CLINICAL MEDICINE, 2004, 4 (05) :448-453
[24]  
Nassaji M., 2016, Eastern Journal of Medicine, V21, P26, DOI 10.5505/ejm.2016.95605
[25]   Compression for venous leg ulcers [J].
O'Meara, Susan ;
Cullum, Nicky ;
Nelson, E. Andrea ;
Dumville, Jo C. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2012, (11)
[26]  
Pavlotsky Felix, 2004, J Dtsch Dermatol Ges, V2, P89, DOI 10.1046/j.1439-0353.2004.03028.x
[27]   Cellulitis A Review [J].
Raff, Adam B. ;
Kroshinsky, Daniela .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 316 (03) :325-337
[28]  
RCore Team, 2018, R LANG ENV STAT COMP
[29]   Diagnosis and management of cellulitis [J].
Sullivan, Tadhg ;
de Barra, Eoghan .
CLINICAL MEDICINE, 2018, 18 (02) :160-163
[30]   Cellulitis [J].
Swartz, MN .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (09) :904-912