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Evaluation of Vibro-pulse in the Treatment of Cellulitis of the Lower Limb

Cellulitis. Definition

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Evaluation of Vibro-pulse in the Treatment of Cellulitis of the Lower Limb

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    1. Evaluation of Vibro-pulse in the Treatment of Cellulitis of the Lower Limb Sue Johnson RN MA NP CNS Wound Care Vascular Unit

    2. Cellulitis Definition acute infection of the skin and subcutaneous tissues, characterised by local heat, pain, redness and swelling (Morton & Shwartz 2004)

    3. Cellulitis Treatment times range from 8 10 hospital bed days Incidence 15.8 per 1000 person years 69,576 hospital admissions 400,000 bed days pa

    4. Cellulitis Commonly occurs in lower leg Streptococci & Staphylococcus Aureus Potential entry sites Leg ulcers Toe web maceration Tinea pedis Traumatic wounds

    5. Cellulitis Predisposing factors Lymphoedema PVD Diabetes Obesity

    6. Cellulitis Diagnosis problematic often confused with: Varicose eczema DVT Thrombophlebitis Oedema with blisters

    7. Cellulitis Leads to: Chronic oedema in 7% of pts Recurrence in 29% of pts within 3 years

    8. Standard treatment Hospital admission IV antibiotics Bed rest Elevation

    9. Vibro-pulse Non invasive vibration Stimulates fluid turnover Increases microcirculation

    10. Study RCT Comparison between standard treatment & Standard treatment + Vibro-pulse

    11. End points Primary Time for resolution of cellulitis Secondary Amount of antibiotics required Effect on length of inpatient stay

    12. Enrolment Male/ female with lower limb cellulitis Exclusions Under 18yrs Pregnant DVT in last 6 months Non-compliant

    13. Outcome measurements Photographs Circumference of calf & thigh WCC, CRP % of cellulitis resolution TPR, BP Pain score

    14. Results 36 patients 17 male, 19 female Control group 5 male, 13 female Mean age 66 yrs Study group 12 male, 6 female Mean age 67 yrs

    15. Results Concommitant disease Previous DVT CVA IHD Hypertension Control group 56% Study group 83%

    16. Results

    17. Results Pain Control group Reduced in all cases by day 7 75% achieved 0 by day 4 Study group Reduced in all cases by day 7 75% achieved 0 by day 2

    18. Results Antibiotics used Benzylpennicillin Flucloxacillin Metronidazole

    19. Results IV antibiotics Control group 83% (100% resolution 1) Study group 72% (100% resolution 11) Oral antibiotics Control Group 17% (100% resolution 1) Study group 28% (100% resolution 2)

    20. Results

    21. Clinical outcome Clinical guideline Further research IV v Oral antibiotics?? Tx as outpatient ??

    23. Any Questions

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