Topical arnica and mucopolysaccharide polysulfate (hirudoid) to decrease bruising and pain associated with haemodialysis cannulation - related infiltration: a pilot study

Topical treatments such as Arnica cream and mucopolysaccharide polysulfuric acid (contained in Hirudoid cream) have been used to treat the bruising and pain arising from dialysis-related infiltrations.
Aim: 
To undertake a randomised controlled pilot study comparing the efficacy of Arnica and Hirudoid creams in treating bruising and pain following post-needling infiltration.
Methods: 
One dialysis centre of 40 patients over a 12-month period. Following infiltration, and at the five subsequent dialysis treatments, pain was measured using the Abbey pain scale and size of the bruise was recorded.
Results: 
Eleven cases of infiltration were recorded consisting of seven males (64%) and four females (36%) who had a mean age of 78 years (SD=9). Access for eight patients was via arteriovenous fistula and for three patients via arteriovenous graft. Eight patients experienced bruising and two patients reported mild pain post-infiltration but there were no differences found between the effect of Arnica or Hirudoid in treating either symptom.
Conclusion: 
This pilot study was unable to detect any differences in the effect of Arnica and Hirudoid on pain or bruising. The study demonstrated that a larger, multicentre trial would be required to power a study and that a non-interventional control group should be added.