Comparison of cadexomer iodine and dextranomer for chronic venous ulcers

Forty‐two patients with chronic resistant varicose ulcers were observed for 6 weeks on standard out‐patient therapy, and then randomly allocated to daily treatment with either cadexomer iodine (CI), a new topical agent, or dextranomer for a further 6 weeks, at which time ulcers judged clinically not to be responding could be changed to the other treatment for the remaining 20 weeks of the trial. There was no significant reduction in ulcer area during the first 6 weeks on CI or dextranomer. A significant preference for CI was shown by the optional crossover. Retrospective analysis of ulcer size shows this was not related to severity and preference was probably due to bias towards the new treatment, the trial not being blind. Neither therapy significantly reduced colonization by β‐haemolytic Streptococcus, Staphytocoaus aureus, Pseudomonas or Proteus. The discrepancy between these and previous findings with CI is largely due to different methods of analysis rather than different results. We conclude that, in chronic resistant venous ulcers, topical therapy is of little importance compared with measures which improve tissue oxygenation and repair.