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Prognostic factors associated with healing of venous leg ulcers: a multicentre, prospective, cohort study
Author(s) -
Chaby G.,
Senet P.,
Ganry O.,
Caudron A.,
Thuillier D.,
Debure C.,
Meaume S.,
Truchetet F.,
Combemale P.,
Skowron F.,
Joly P.,
Lok C.
Publication year - 2013
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12570
Subject(s) - medicine , family medicine
Summary Background Some prognostic markers of venous leg ulcer ( VLU ) healing have been evaluated, mostly in retrospective studies. Objectives To identify which clinical characteristics, among those known as possible prognostic factors of VLU healing, and which VLU ‐associated sociodemographic and psychological factors, are associated with complete healing at week 24 ( W 24). Methods A prospective, multicentre, cohort study was conducted in 22 F rench dermatology departments between S eptember 2003 and D ecember 2007. The end point was comparison between healed and nonhealed VLU s at W 24, for patient clinical and biological characteristics; psychological, cognitive and social assessments; affected leg inclusion characteristics; venous insufficiency treatment and percentage of initial wound area reduction during follow‐up. Results In total, 104 VLU s in 104 patients were included; 94 were analysed. The mean VLU area and duration were 36·8 ± 55·5 cm 2 and 24·8 ± 45·7 months, respectively. At W 24, 41/94 VLU s were healed. Univariate analysis significantly associated complete healing with superficial venous surgery ( P = 0·001), adherence to compression therapy at W 4 ( P = 0·03) and W 24 ( P = 0·01), ankle‐joint ankylosis ( P = 0·01) and mean percentage of VLU area reduction at W 4 ( P = 0·04). Multivariate analysis retained superficial venous surgery during follow‐up [odds ratio ( OR ) 8·4, 95% confidence interval ( CI ) 1·9–48·2] and percentage reduction of the VLU area at W 4 ( OR 1·6, 95% CI 1·0–2·14) as being independently associated with healing. Conclusions These results indicate that complete healing of long‐standing, large VLU s is independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.