A Forssgren1, O Nelzén. 1. Department of Dermatology, Skaraborg Hospital, Skövde, Sweden. alexandra.forssgren@vgregion.se
Abstract
OBJECTIVE: The study aims to compare the spectrum of leg ulcer aetiology in Skaraborg County in 1988 and 2002, an evaluation of 14 years of targeted leg ulcer intervention. DESIGN: Cross-sectional study within the professional health-care system in Skaraborg County. MATERIALS: In 2002, 621 leg ulcer patients were identified through a cross-sectional population survey. METHODS: Half of the registered patients were randomly selected and offered clinical examination. A total of 198 patients with 246 legs underwent examination and were categorised in detail according to aetiology. Data were compared with the initial study in 1988. RESULTS: Venous incompetence was present in 140 (57%) legs and the dominating cause in 94 (38%) of the leg ulcers, 40 (16%) due to deep venous incompetence. Arterial insufficiency was identified in 90 (37%) legs and the dominating aetiological factor in 41 legs (17%), eight (3%) being critical ischaemic ulcers. The relative risk (RR) of developing a leg ulcer in 2002 vs. 1988 was 0.77. The RR of a venous ulcer was reduced by 46%, arterial by 28%, while there was an increase in diabetic ulcers by 29% and multifactorial by 42%. CONCLUSION: The aetiological spectrum of leg ulcers has changed, most likely due to a new management strategy in the care of leg ulcer patients.
OBJECTIVE: The study aims to compare the spectrum of leg ulcer aetiology in Skaraborg County in 1988 and 2002, an evaluation of 14 years of targeted leg ulcer intervention. DESIGN: Cross-sectional study within the professional health-care system in Skaraborg County. MATERIALS: In 2002, 621 leg ulcerpatients were identified through a cross-sectional population survey. METHODS: Half of the registered patients were randomly selected and offered clinical examination. A total of 198 patients with 246 legs underwent examination and were categorised in detail according to aetiology. Data were compared with the initial study in 1988. RESULTS: Venous incompetence was present in 140 (57%) legs and the dominating cause in 94 (38%) of the leg ulcers, 40 (16%) due to deep venous incompetence. Arterial insufficiency was identified in 90 (37%) legs and the dominating aetiological factor in 41 legs (17%), eight (3%) being critical ischaemic ulcers. The relative risk (RR) of developing a leg ulcer in 2002 vs. 1988 was 0.77. The RR of a venous ulcer was reduced by 46%, arterial by 28%, while there was an increase in diabetic ulcers by 29% and multifactorial by 42%. CONCLUSION: The aetiological spectrum of leg ulcers has changed, most likely due to a new management strategy in the care of leg ulcerpatients.