Kelechi Teresa J, Mueller Martina, King Dana E, Madisetti Mohan, Prentice Margie
Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street MSC 160, Charleston, SC 29425, USA.
Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street MSC 160, Charleston, SC 29425, USA.
J Tissue Viability. 2015 May;24(2):71-9. doi: 10.1016/j.jtv.2015.01.006. Epub 2015 Feb 7.
People with chronic venous disease are at high risk for developing venous leg ulcers. Inflammation is posited as a pathological factor for this chronic condition as evidenced by persistently elevated skin temperature. As part of a larger trial to test the effects of a cooling regimen on leg ulcer prevention, the objective of this preliminary study was to evaluate the first 30 days of intense daily cooling. Compared to a placebo control cuff, a gel cuff applied to the most severely affected lower leg skin for 30 min daily showed no statistically significant differences between temperatures taken in the home at baseline compared to those measured at the 1 month follow up visit. There were also no differences in temperatures noted between the two groups, although the temperatures in the treatment group were lower 30 min after treatment, an indication of adherence. There was no discernable decrease or increase in temperature at a given time point during the 30 day treatment period compared to the control group. It may be better to have patients monitor skin temperature on a daily basis and then apply the cuff as necessary, rather than requiring daily cooling based on baseline measurement. This "prn" approach may provide a sufficient cooling milieu to prevent escalation of inflammation and thwart ulcer occurrence or recurrence. Clinical trials registration #NCT01509599.
患有慢性静脉疾病的人发生腿部静脉溃疡的风险很高。炎症被认为是这种慢性疾病的一个病理因素,持续升高的皮肤温度就是证据。作为一项测试降温方案对预防腿部溃疡效果的大型试验的一部分,这项初步研究的目的是评估头30天每天进行强化降温的情况。与安慰剂对照袖带相比,每天在受影响最严重的小腿皮肤上使用凝胶袖带30分钟,在家中测量的基线温度与1个月随访时测量的温度之间没有统计学上的显著差异。两组之间的温度也没有差异,尽管治疗组在治疗后30分钟时温度较低,这表明患者坚持使用了袖带。与对照组相比,在30天的治疗期内,给定时间点的温度没有明显下降或上升。让患者每天监测皮肤温度,然后根据需要使用袖带,可能比根据基线测量要求每天进行降温更好。这种“按需”方法可能提供足够的降温环境,以防止炎症升级并阻止溃疡的发生或复发。临床试验注册号#NCT01509599。