Moffatt 2014a.

Methods	Cohort comprised participants in the intervention arm of an RCT of oxyzyme/iodozyme vs control (usual treatment) Setting: community leg ulcer service Country: UK Duration of follow‐up: 12 weeks Treatments: oxyzyme/iodozyme plus secondary dressing (film, surgipad/thin foam according to exudate level). All used appropriate compression
Participants	47 participants with VLU or arterial leg ulcers (26 VLU, 21 mixed A‐V) Mean age: 69.7 (SD 13.2) years; similar for both groups Sex (M:F): 23:24 Stage of ulcer: not reported Ulcer duration: mean: 17.6 (SD 40.3) months Ulcer size at baseline: mean 8.1 (SD 10.2) cm² Wound infection: no cellulitis (exclusion criteria), but wound infection not mentioned Number of wounds: unclear (1 limb per participant but (overall) 13 noted as having ulcer on contralateral limb so possibly 113 wounds) Inclusion criteria: aged ≥ 18 years, venous (ABPI > 0.8) or mixed (ABPI > 0.6) ulcer 2‐50 cm², mild or moderate exudate, healthy peri‐wound skin Exclusion criteria: pregnancy, breastfeeding, acute DVT within 3 months, surgery for chronic venous insufficiency within 2 months, surgery for peripheral arterial occlusive disease within 3 months, cellulitis, thyroid treatment, known hypersensitivity to components of new dressings; peri‐wound maceration or uncontrolled varicose eczema around the ulceration
Prognostic factors	MMP (unspecified) (dichotomous data); MMP activity. Measurement method enzyme detection device for detecting or measuring the presence in a test sample of the activity of an enzyme capable of cleaving a substrate: reverse ELTABA (Mologic Ltd.) Time of measurement: baseline Wound fluid sampling method: swabs (taken at dressing change)
Notes	Results reported separately for the 2 randomised groups because oxyzyme/iodozyme suggested to be protease modulating
Risk of bias
Bias	Authors' judgement	Support for judgement
Selection bias	Low risk	All participants considered who met the inclusion criteria
Attrition bias	Unclear risk	Moderate: 6/47 (13%) participants discontinued in intervention group; unclear if important
Prognostic factor measurement	Unclear risk	Moderate: cut‐off defined on 0‐10 scale; unclear if validated: score of ≥ 5 considered to be high protease activity
Outcome measurement	High risk	Not blinded, investigator present at all times and assessed the outcome
Adjustment factors	High risk	None of the key adjustment factors taken into account in the design or analysis
Analysis and reporting	High risk	Possible interaction with treatment (which proposed to be protease modulating); not taken into account in analysis
Overall risk of bias	High risk