Document Detail


Significance of limb trauma as an initiating factor in chronic leg ulceration.
MedLine Citation:
PMID:  18467622     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess differences in clinical outcomes between patients with traumatic and spontaneous leg ulcers. METHODS: Consecutive leg ulcer follow-up patients seen between April 2004 and October 2005 in a specialist leg ulcer clinic were asked about the mechanism of the original ulceration. Twenty-four-week healing and 12-month recurrence rates were calculated using Kaplan-Meier analysis and outcomes were compared between groups with traumatic and spontaneous ulcers. RESULTS: Of the 300 patients assessed, 38 were excluded (incomplete data). In the remaining 262 patients, cause of ulceration was traumatic in 116/262 (44%) and spontaneous in 146/262 (56%). Age, ankle brachial pressure index <0.85 and venous reflux were equally distributed between groups with traumatic and spontaneous ulcers (P = 0.470, 0.793, 0.965 respectively, Chi-square test). Twenty-four-week healing rates were 81% for traumatic and 67% for spontaneous ulcers (P = 0.015, Log-Rank test). Twelve-month recurrence rates were 32% for traumatic and 33% for spontaneous ulcers (P = 0.970, Log-rank test). Patients with traumatic ulcers suffered a total of 53 ulcer recurrences (median 0, range 0-4) compared with 89 in patients with spontaneous ulcers (median 0, range 0-8) (P < 0.001, Mann-Whitney U test). CONCLUSION: Approximately half of all leg ulcer patients recall a traumatic event. When managed in leg ulcer clinic, traumatic ulcers heal faster and recur less frequently than spontaneous ulcers.
Authors:
S R Kulkarni; M S Gohel; M R Whyman; K R Poskitt
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Phlebology / Venous Forum of the Royal Society of Medicine     Volume:  23     ISSN:  0268-3555     ISO Abbreviation:  Phlebology     Publication Date:  2008  
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-08-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012921     Medline TA:  Phlebology     Country:  England    
Other Details:
Languages:  eng     Pagination:  130-6     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire GL53 7AN, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chronic Disease
Female
Humans
Kaplan-Meiers Estimate
Leg Injuries / complications*,  epidemiology,  physiopathology*
Leg Ulcer / epidemiology,  etiology*,  physiopathology*
Male
Middle Aged
Recurrence
Risk Factors
Wound Healing*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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