Swelling in the legs, more commonly referred to as chronic edema of legs, can cause a common but serious and painful bacterial skin infection known as ‘cellulitis’. The condition can be treated by antibiotics but the medication is not always the answer.
Therefore, an Australian research team has used the compression therapy that showed positive outcomes in reducing the cases of cellulitis, says a recent small but important study. The findings of the study have been published in the New England Journal of Medicine (NEJM).
Interventions other than Abx that improve outcome in cellulitis are welcomed
A small single-center NB trial pts w chronic edema of the leg&cellulitis compression therapy ⬇️ incidence of recurrence of cellulitis than conservative treatment @NEJM #IDTwitter https://t.co/7tzNyWT9zO
— Antibiotic Steward🆔 Bassam Ghanem (@ABsteward) August 13, 2020
The researchers have conducted a single-center, randomized, nonblinded trial that aimed to find out an association between the compression therapy and controlled incidents of chronic edema of the leg and people with cellulitis that can be defined as an infection of the skin that involves subcutaneous tissues or the innermost layer of the skin. Cellulitis can be caused by trauma or scratching of other lesions due to animal or human bites that result in fever, extreme pain, and redness of the skin.
The investigators have screened a total of 183 participants. The sample consisted of 84 people who were extracted from the total according to the study criteria.
Later on, the team divided the data into two groups. The first group was known as a compression group that received compression therapy which is a simple and effective technique that targets the blood flow activity in the lower limbs or empowering the circulation in legs and strengths the veins. The compression intervention improves the venous function or the networks of veins without compromising arterial function.
Mainly, the therapy involved in reducing the swelling from the legs that can be a cause of the development of cellulitis. It improves blood circulation and relieves pain or heaviness in the legs.
The criteria for the current study were to administer compression therapy and give education about cellulitis which is significantly prevalent among males and an age group of 45 to 64. Around 24.6 per 1000 person-year incident rate of cellulitis, according to an estimation published by the National Center for Biotechnology Information (NCBI). Person-year or person-month can be defined as the number of participants included in the study and the amount of time which is spent by the study participants during the cohort.
However, the first group had 41 participants that received compression therapy after every six months for the three years consecutively 45 episodes of cellulitis had occurred in the trial. On another hand, the second controlled group had 43 participants that gained only education about cellulitis.
Primary Outcomes: After the analysis, the team found out 23 recurrent episodes of cellulitis of which six and 17 participants were from the compression group and controlled group, respectively.
Later on, the team focused on those patients who been hospitalized due to cellulitis. The second area of interest of the investigators was to measure the quality of life of those hospitalized patients.
Secondary Outcomes: The team came to know that a total of three and six participants from the compression group and controlled group, respectively, were found to be hospitalized due to cellulitis. There was no significant difference in the quality of life and adverse events have been found in both groups during the study.
The chief author of the study Elizabeth Webb of Calvary Public Hospital Bruce in Canberra said:
“Our results are a game-changer in that we can now be very confident that compression therapy significantly reduces risk recurrence in patients with chronic edema and a history of 2 or more episodes of leg cellulitis by a magnitude of 77%”.
The findings of the current study can be of great help for those medical health professionals that are currently dealing with those patients who are suffering from chronic edema of the leg or cellulitis. The use of long term antibiotic treatment can reduce the recurrent episodes of cellulitis but the medication have found to be less effective for many cases such as obese people. Therefore, experts can use compression therapy for reducing the incidents of cellulitis.
Web added: “Not only will the compression therapy control leg swelling, but it will also substantially reduce the risk of another bout of cellulitis”.
The study was funded by the Calvary Public Hospital Bruce.