Oral zinc sulphate in the treatment of venous leg ulcers. Double-blind trial of zinc sulphate in the treatment of chronic venous leg ulceration. Double-blind trial of oral zinc sulphate in patients with leg ulcers. Oral zinc sulphate and ischaemic leg ulcers. The beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: a proof-of-concept study. Venous leg ulceration: evaluation of zinc treatment, serum zinc and rate of healing. Serum-zinc and healing of venous leg ulcers. The influence of dressings on venous ulcer healing--a randomised trial. [Effect of zinc oxide tape on plantar ulcers in leprosy patients in Indonesia].
nan nan nan nan Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial.
                To assess the clinical relevance of histological findings following antimicrobial applications on chronic leg ulcers.
                The present study was performed in three parallel groups of 17 patients suffering from at least 2 similar chronic leg ulcers. Clinical planimetric assessments were performed before and after 3 and 6 weeks of treatment using hydrocolloid dressings. In addition, 1 ulcer in each patient received applications of povidone-iodine (PVP-I), silver sulfadiazine or chlorhexidine digluconate. Histological examinations were made at inclusion and after the 6-week therapy. Time to healing was also recorded.
                At entry in the study, fibroblasts, macrophages, neutrophils and vessels were abundant in the ulcers. In addition, focal necrotizing vasculitis was related to the microbiological load. Compared to the control lesions, both the healing rate and time to healing of the leg ulcers showed a modest improvement at the sites receiving silver sulfadiazine (2-7%) or chlorhexidine digluconate (-1 to 5%). By contrast, PVP-I increased significantly the healing rate (4-18%, p < 0.01), and time to healing was reduced by 2-9 weeks (p < 0.01). The 3 antimicrobials decreased the bacterial density, and the vascular margination and migration of inflammatory cells, thus abating the vasculitic changes. PVP-I applications did not alter the microvessels and did not significantly reduce the density in dendrocytes and fibroblasts. By contrast, both silver sulfadiazine and chorhexidine digluconate appeared to alter the superficial microsvasculature including the dendrocyte population.
                Although topical antimicrobials may apparently achieve almost similar activity on the bacterial load inside chronic leg ulcers, the toxicity upon host cells was different among these agents. PVP-I appeared to be an efficient compound in these respects exhibiting a positive and relevant clinical effect.
                Copyright 2002 S. Karger AG, Basel nan nan To assess the effect of different dressings on venous ulcer healing.
                A randomised clinical trial.
                Patients were randomised to treatment with one of three dressings: a zinc oxide impregnated bandage, a zinc oxide impregnated stockingette, or an alginate dressing. All patients were treated as outpatients and had compression bandaging with two minimal stretch bandages (Elastocrepe) and a stockingette (Tubigrip) to keep the bandages in place.
                One hundred and thirteen patients (133 ulcerated limbs) with chronic ulceration of the leg due to venous disease alone, and attending Fremantle Hospital Leg Ulcer Clinic, Western Australia were entered into the study. Healing was measured as complete healing of the ulcerated limb or failure of the limb to heal within 9 months.
                There was no significant difference between the three groups in ulcer size, duration, and other parameters compared. Healing was affected significantly by ulcer size and which leg was ulcerated. There was significantly faster healing with the paste bandage.
                The use of a paste bandage significantly improved the healing of chronic venous ulcers when used in combination with compression bandaging, and compared to an alginate dressing and a zinc oxide impregnated stockingette. In this investigation the effectiveness was studied of adhesive zinc oxide tape, as additional therapy to the usual application of povidone iodine (10%), for leprosy patients with plantar ulcers in Sulawesi Tengah, Indonesia. The effectiveness (degree of wound healing measured as surface reduction) of this experimental therapy was compared with that of the usual therapy alone. At the same time the influence of the physical activity level on the effectiveness of both therapies was studied. During six weeks 38 leprosy patients with simple ulcers were treated with either one of the therapies. The average wound healing of the experimental group and the control group was 388 mm2 (SD 498) and 260 mm2 (SD 260) respectively. Using the t-test, there was no statistically significant difference in wound healing between the two therapies (p = 1.7). The average wound healing of the experimental group with a high and a low activity level was 342 mm2 (SD 226) and 405 mm2 (SD 571) respectively. The average wound healing of the control group with a high and low activity level was 246 mm2 (SD 289) and 275 mm2 (SD 232) respectively. Using analyses of variance, there was no statistically significant influence on the effectiveness of the therapies (p greater than 0.1). Methodological problems possibly influenced on the results. Different problems which may be encountered during research in third world countries are mentioned.
Oral zinc sulphate does not appear to aid the healing of arterial and venous leg ulcers, however all included studies were small and at unclear risk of bias (due to poor reporting).