Impact of Compression Therapy on Cellulitis (ICTOC) in adults with chronic oedema: a randomised controlled trial

Research questions: 1. To determine if compression therapy prevents the recurrence of lower limb cellulitis in adults with lower limb chronic oedema and recurrent cellulitis. 2. To determine and compare the cost of an episode of cellulitis and the cost of compression therapy over 18-months from both patient and health service perspectives. Background information and results: Trial inclusion criteria included adults with chronic oedema and a history of 2 or more episodes of cellulitis in the same leg in the 2 years prior to trial referral. Participants were randomised to receive either education regarding cellulitis prevention (control group) or the same education plus compression therapy (experimental group). Participants were planned to be followed up 6-monthly for up to 3 years or until 45 episodes of cellulitis occurred. The primary outcome was time to cellulitis recurrence. At the time of a planned interim analysis, cellulitis had recurred in 6 (15%) of the experimental group participants, and 17 (40%) of the control group participants, giving a hazard ratio of 0.23 (95% CI, 0.09 to 0.59; P=0.002). During the RCT, the mean annual cost per participant was $4972 in the experimental group and $26,382 in the control group, giving a cost saving of $21,483 (95% CI, 3136–48,176) per participant.