EMLA Anaesthetic Cream for Sharp Debridement of Venous Leg Ulcers: A Double-Masked, Placebo-Controlled Study

Objective: The aim of this double-masked, placebo-controlled trial was to confirm the anaesthetic effect of EMLA cream compared with placebo when used for sharp debridement of venous leg ulcers and to test its feasibility with respect to the usual procedure. Methods: One hundred and ten patients with venous ulcers were randomised to EMLA or placebo cream treatment for 30-45 min. Pain from debridement was evaluated by the patient on a 100 mm visual analogue scale (VAS) and by the physician on a verbal scale. Results: The median VAS scores were 16.5 and 52 in EMLA- and placebo-treated patients, respectively (p<0.00001), a clinically relevant difference. On the vertebral scale 61% of EMLA patients and 21% of placebo patients were placed in the category of no pain (pO.OOOl). The physicians found debridement with EMLA easier to perform (p<0.01). Conclusion: Debridement of venous leg ulcers using topical anaesthesia is easy and safe, with adequate pain relief in both in- and outpatients.

[1]  A. Tong.  The identification and treatment of slough. , 1999, Journal of wound care.

[2]  P. Vowden,et al.  Wound debridement, Part 2: Sharp techniques. , 1999, Journal of wound care.

[3]  P. Vowden,et al.  Wound debridement, Part 1: Non-sharp techniques. , 1999, Journal of wound care.

[4]  B. Guillot,et al.  EMLA cream as a topical anesthetic for the repeated mechanical debridement of venous leg ulcers: a double-blind, placebo-controlled study. , 1999, Journal of the American Academy of Dermatology.

[5]  A. Håkansson,et al.  Pinch grafting of leg ulcers in primary care. , 1998, Acta dermato-venereologica.

[6]  T. Ryan,et al.  Pain in venous leg ulcers. , 1997, Journal of wound care.

[7]  N. Simpson,et al.  Guidelines for the management of chronic venous leg ulceration. Report of a multidisciplinary workshop , 1995, The British journal of dermatology.

[8]  C. Hansson,et al.  Repeated treatment with lidocaine/prilocaine cream (EMLA) as a topical anaesthetic for the cleansing of venous leg ulcers. A controlled study. , 1993, Acta dermato-venereologica.

[9]  E. C. Huskisson,et al.  Graphic representation of pain , 1976, Pain.

[10]  A. Tong.  The identification and treatment of slough A review of the problems encountered by clinicians in identifying slough in wounds and selecting debridement therapies for its removal , 1999 .

[11]  L. Mather,et al.  Clinical pharmacology of local anaesthetic agents , 1999 .

[12]  J. Holm,et al.  Pain control in the surgical debridement of leg ulcers by the use of a topical lidocaine--prilocaine cream, EMLA. , 1990, Acta dermato-venereologica.