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The importance of pathogenic bacteria in venous leg ulcers was analysed in a randomized open trial divided into 2 parts. During the first 2-week period the effects of physiological saline and dextranomer beads were compared. During the following 8 weeks the effect of porcine skin, aluminium foil and a double layer bandage were compared. The assessment of the results of treatment was based on the area and volume of the ulcer measured by stereophotogrammetry and the bacteriological findings. Staphylococcus aureus was the commonest isolated species. Mixed cultures comprising Staph. aureus and gram-negative bacteria were the next commonest finding. There was a low frequency of isolation of anaerobic bacteria. The bacteriological findings were similar in the different treatment groups. The nature of the bacterial isolates and the colonization estimated by a contact-transfer procedure bore no relationship to the clinical assessment as to whether the ulcer was clean or purulent. Healing of the ulcer was not influenced by the bacteria present. The findings seem to indicate that as a rule the bacteria in the ulcers are saprophytic and will disappear when the favourable environment for their growth is lost.

A total of 113 patients with recurrent genital herpes were enrolled in a multicentre cross-over study. Two consecutive recurrences were treated with either oral acyclovir 200 mg or matching placebo five times daily for five days. Acyclovir significantly reduced the time to crusting and healing and the duration of new lesions and symptoms. Acyclovir was not found to have any clinically significant effect on the haematological or biochemical parameters measured, or to have caused adverse events and was well tolerated. Early self-initiated treatment may abort a recurrent attack of genital herpes without progression to the ulcerative or crusting stage.

This report describes stereophotogrammetric measurements of leg ulcers. A basic technical description of the method and its application in a pilot study are presented. The clinical evaluation of the healing of leg ulcers is compared to the photogrammetrically determined parameters--edge length, surface area, and volume--of the ulcers, and seems to fulfil the need for an objective method in the evaluation of leg ulcer treatment.

A randomized controlled study was performed in 34 patients with venous leg ulcers. No difference was found in the healing rate between a new hydrocolloid dressing plus compression, and a double layer bandage, consisting of an inner paste bandage (i.e. a stocking impregnated with zinc oxide paste) and an outer elastic bandage. The parameters chosen for objective evaluation were stereophotogrammetric measurement of ulcer area and volume, and bacterial counts.

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20 patients with rosacea were treated with a 1% metronidazole cream b.i.d. for one month. Sixteen out of twenty patients improved. The skin and intestinal microflora were studied before, during and after treatment. Topical metronidazole did not cause any significant changes in the microflora. No side effects were observed.