Tratamiento tópico sobre úlceras varicosas de evolución tórpida con ampollas monodosis estériles de ciprofloxacino. La efectividad frente a suero fisiológico

Abstract

ObjectiveTo determine the efficacy of topical application of sterile ciprofloxacin solution and physiologic serum as local treatment of venous ulcers compared with that of physiologic serum alone. DesignTherapeutic crossover trial. Material And MethodsA crossover study was performed. Patients with varicose lesions of more than 3 weeks’ duration (n = 63) were included. The mean age was 76.33 ± 16.79 years. There were 21 men (33%; 69.9 ± 19.9 years) and 42 women (67%; 80.2 ± 12.3 years). The sample was divided in two groups: group A (n = 63) received moisture semiocclusive therapy with single-dose ciprofloxacin ampoules and physiologic serum (NaCl 0.9%) applied by syringe 20 cc and disposable needle plus cotton gauzes (3-4 per application); group B (n = 63) received physiologic serum alone, used for a maximum of 2 weeks. ResultsIn the crossover study, the response was positive in 29 patients in group B and in 41 in group A (65 vs 46%; p = 0.000). The percentage decrease in wound area was 31.2 vs 9.3%; 1.46 vs 0.47 cm2, p = 0.00 (group A vs group B). The results of cultures for the crossover study were: 37.5% Pseudomonas, 17.6% sterile, 17.1% group D Streptococcus, and 14.1% saprophyte flora. ConclusionsCombined treatment of long-standing varicose lesions with topical ciprofloxacin and physiologic serum seems to achieve a greater initial response than the use of physiologic serum alone. The presence of fibrin at the beginning of treatment with serum does not seem to modify subsequent response to fibrin. Addition of topical ciprofloxacin to lesions without fibrin improves response compared with physiologic serum alone.