Factors that influence healing of chronic venous leg ulcers: A retrospective cohort

Background: venous ulcers have a significant impact on patient quality of life,and constitute a worldwide public health problem. treatment is complex,with high failure rates. objectives: to identify clinical and therapeutic factors that influence healing of venous ulcers. methods: retrospective cohort study of patients with venous ulcers. ulcer area was measured at the first visit (t0) and after 6 months (t6) and 1 year (t12). a reduction in ulcer area of 50% or more at t6 and t12 was the outcome of interest,weighted by clinical,demographic and treatment aspects. results: ninety-four patients were included (137 ulcers). a reduction in ulcer area of 50% or more was seen in 40.1% of patients (95%ci 31.9 to 48.4%) at t6 and 49.6% (95%ci 41.2 to 58.1%) at t12. complete healing occurred in 16.8% (95%ci 10.5 to 23.1%) at t6 and 27% (95%ci 19.5 to 39.5%) at t12. the lowest ulcer area reductions at t6 were associated with longstanding ulcer (rr=0.95; 95%ci 0.91 to 0.98),poor adherence to compression therapy (rr=4.04; 95%ci 1.31 to 12.41),and infection episodes (rr= 0.42; 95%ci 0.23 to 0.76). at t12,lower reductions were associated with longstanding ulcer (rr=0.95; 95%ci 0.92 to 0.98),longer topical antibiotic use (rr=0.93; 95%ci 0.87 to 0.99),and systemic antibiotic use (rr=0.63; 95%ci 0.40 to 0.99). conclusions: longstanding ulcer,infection,poor adherence to compression therapy,and longer topical and systemic antibiotic use were independently correlated with worse healing rates. © 2014 by anais brasileiros de dermatologia.