Prognostic factors for venous ulcer healing in a non-selected population of ambulatory patients

Abstract

Clinical indicators such as simple ulcer length measurement and ulcer duration may help physicians to detect patients with a prognosis of poor healing.

Prognostic factors for delayed healing of venous leg ulcers

“…Also, it remains unclear whether demographic characteristics of VLU patients or their co-morbidities are really associated with impaired healing. Some studies demonstrated a delayed healing in elderly patients [12,16,18,26] while others found a better healing in this age group [19] or no association of the age with healing [8,10,13]. In one study the patients aged less than 40 years were more likely to have VLUs healed in a short time [15].…”

“…Most of these studies gave a concise picture. Parameters predicting poor outcome comprise large ulcer size [5][6][7][8][9][10][11][12][13][14][15][16][17] and long ulcer duration [5, 6, 8-10, 12-16, 18, 19]. However, the cutoff values of the size and duration varied between the studies, probably because of different cohorts assessed (for example: all VLU patients in the community, only selected patients, those included into the clinical trials).…”

“…However, the cutoff values of the size and duration varied between the studies, probably because of different cohorts assessed (for example: all VLU patients in the community, only selected patients, those included into the clinical trials). Ulcer size was either defined in terms of its area -and the value predicting a delayed healing was either more than 10 cm 2 [6,9,10,20] or more than 20 cm 2 [13], or in terms of the ulcer's diameter, with the cutoff predicting poor outcome: more than 10 cm [12,15]. By contrast, very small ulcers (up to 1 cm in diameter) were more likely to heal within a short time [15].…”

“…All, except for one [21] of the published studies revealed a delayed healing of longstanding VLUs. However, the time predicting poor outcome was very different: more than 3 months [12], more than 6 months [6,20], more than 12 months [9,10,13], more than 18 months [19], or more than 24 months [15]. Another reported prog-…”

“…Phlebological Review 2014 nostic factor of unfavourable clinical outcome was lack of healing or small decrease of the ulcer area after dedicated time of standard management: 3 weeks [14], 4 weeks [12,[21][22][23][24][25], or 50 days [13]. Moreover, some authors reported delayed healing in cases of history of previous leg ulceration [17,26], but such an association was not found by others [7,15,19].…”