Katarina Slavich
13 August 2020: University of Canberra PhD student Elizabeth Webb’s research has reached international shores with the results of her world-first randomised trial published in the prestigious New England Journal of Medicine. Ms Webb’s research tests the theory that compression therapy could reduce the frequency that patients were contracting the common skin infection cellulitis.
Cellulitis is a painful bacterial skin infection that is the fourth most common reason for a patient to present to the emergency department, contributing to almost 130,000 patient presentations per year in Australia.
It can occur in anyone, and anywhere on the body – however most often it affects the lower legs, particularly in those who have chronic swelling. Once a patient has one episode of cellulitis, they have up to a 50 per cent chance of a recurrent episode within a few years.
Back in 2017, Ms Webb and her lymphoedema physiotherapy team at Calvary Public Hospital in Bruce wanted to explore whether compression therapy, which they commonly used for the treatment of chronically swollen legs, would also reduce the frequency of episodes for patients being burdened by cellulitis.
In the past, experts in the field have suggested that compression therapy was a key component in preventing cellulitis in these patients, but there hadn’t been any research to confirm the theory.
The effect of Ms Webb’s trial was so powerful, it had to be stopped early for ethical reasons to ensure all patients could receive the compression therapy.
Results showed that for patients with chronic leg swelling, compression therapy reduced the risk of cellulitis by 77 per cent. Until now, the use of prophylactic antibiotics to prevent cellulitis has been the most common practice. However, patients with chronic edema, obesity or a history of multiple episodes of cellulitis have a decreased likelihood of responding to antibiotic prophylaxis. For the many patients at risk of antibiotic failure, there is now another option which can reduce their risk of infection.
“I am delighted that this research has demonstrated our long-held belief that compression therapy is effective in preventing cellulitis in individuals with leg swelling,” said Ms Webb.
“Translation of this knowledge into practice will be of great benefit to Canberrans, but also to all Australians and cellulitis sufferers around the world.”
Now, international audiences will be able to see the success Ms Webb and her team have achieved, with the results published in the world’s leading medical journal and website, the New England Journal of Medicine.
“As the New England Journal of Medicine is one of the most widely read and trusted medical journals in the world, we are so pleased that our message will be broadly disseminated. It is not often that physiotherapy-led research is published in this journal and I believe this publication is a win for both the physiotherapy and allied health voices,” said Ms Webb.
"Chronic oedema is a common but often under-diagnosed and under-treated condition. I hope publication of these results will assist in raising awareness of chronic oedema amongst the medical community."
Ms Webb’s supervisor, Dr Bernie Bissett, says she is proud that the work being done in Canberra is going to have a real impact on patients around the world.
“Elizabeth and the team at Calvary Hospital have done an extraordinary job conducting a world-class randomised trial, and we are so grateful to the people of Canberra who agreed to be part of this study,” said Dr Bissett.
“Being published in the New England Journal of Medicine is clear proof that our clinical research here in Canberra is being taken seriously right around the world – I have never been more proud to be a physiotherapist and a Canberran!”
Dr Bissett says this research is a shining example of how the University’s Faculty of Health is working closely with its clinical partners like Calvary Hospital and Canberra Health Services to deliver the highest calibre clinical research.
“At UC, we are always focused on patients and people as the most important element of our research agenda. Elizabeth’s study at Calvary Hospital is a perfect example of the combination of academic rigour and clinical care. We are so thrilled for her that her excellent work has been published in the New England Journal of Medicine and are excited to see where her research journey takes her next.”
Deputy Vice-Chancellor of Research and Innovation, Professor Leigh Sullivan, says the publication is a remarkable outcome.
“The acceptance of the outcomes of Elizabeth’s clinical trial for publication in this outlet is a clear indication of the outstanding work undertaken by Elizabeth and her co-authors, and the impact of the clinical research on the treatment of cellulitis,” said Professor Sullivan.
“This is clearly an exceptional outcome for Elizabeth – who as well as being lead author is currently a PhD candidate – the University of Canberra and of course, those suffering from cellulitis.”
