title: Carboxymethyl Cellulose, Trichloroacetic Acid, and Unna Boot for Healing Venous Ulcers: A Comparative Study of Their Efficacy and Socioeconomic Impact.
abstract: Chronic ulcers are defined as a breakdown of the long-term cutaneous barrier or frequent recurrence of breakdowns. Dressings are a form of treatment and, in view of the variety and high cost of the products on the market, three agents were selected for this investigation, regarding their efficacy and cost/benefit ratio. The objective of the investigation was to evaluate and compare the efficacy, costs, and benefits of carboxymethylcellulose in paste at 20% (CMC 20%), trichloroacetic acid at 90% (TCA 90%), and Unna boot for treatment of chronic venous ulcers. Three groups of 30 patients each were chosen randomly for ambulatory treatment with TCA 90% (G1), CMC 20% (G2), and Unna boot (G3). The evolution of the cicatricial process of each group separately and between groups was analyzed with measurement of the lesion areas in square centimeters (cm2) and observation of the amount of exudate from observation of the photographic record, until their healing, in the maximum period of 20 weeks. A significant reduction of lesion areas in all groups was observed (P=.0001), with a median reduction of 7.6 cm2(38.1%) for G1, 3.9 cm2(38.8%) for G2, and 16.2 cm2(77.8%) for G3. There was a significant difference in the absolute delta of the lesion areas (P=.0001) of the groups. The three types of treatments promoted effective improvement, with acquisition and utilization of all three products in the public health services being recommended.
authors.affiliation: University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Brazil.|University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.
authors.forename: Sueli
authors.initials: S
authors.lastname: Carneiro
authors.affiliation: University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.|Rio das Ostras Campus/Fluminense Federal University, Rio das Ostras, Brazil.
authors.forename: Virginia
authors.initials: V
authors.lastname: Januário
authors.affiliation: University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.
authors.forename: Maria Leide W
authors.initials: ML
authors.lastname: Oliveira
authors.affiliation: Anna Nery Nursing School, Federal University of Rio de Janeiro, Brazil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: de Oliveira Teixeira
authors.affiliation: University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Brazil.
authors.forename: Solange
authors.initials: S
authors.lastname: Maciel
authors.affiliation: University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Brazil.
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Macedo
authors.affiliation: University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil; ramos.e.silva2@dermato.med.br.
authors.forename: Marcia
authors.initials: M
authors.lastname: Ramos-E-Silva
mesh_terms: D000279:Administration, Cutaneous; D000553:Ambulatory Care / Q000379:methods; D001458:Bandages / Q000191:economics; D002266:Carboxymethylcellulose Sodium / Q000191:economics / Q000627:therapeutic use*; D002908:Chronic Disease; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin / Q000191:economics / Q000627:therapeutic use*; D005990:Glycerol / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome; D014238:Trichloroacetic Acid / Q000191:economics / Q000627:therapeutic use*; D014647:Varicose Ulcer / Q000175:diagnosis* / Q000628:therapy*; D014945:Wound Healing / Q000187:drug effects*; D017967:Zinc Compounds / Q000191:economics / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D017967:Zinc Compounds; C009622:gelatin, glycerin, zinc oxide drug combination; D014238:Trichloroacetic Acid; D005780:Gelatin; D002266:Carboxymethylcellulose Sodium; D005990:Glycerol