Carina C E G Pernot1, Ineke Zwiers2, Arina J Ten Cate-Hoek3, Cees H A Wittens4. 1. Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. 2. Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. 3. Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. Thrombosis Expertise Center, Heart and Vascular Center, Maastricht University Medical Centre, Maastricht, the Netherlands. 4. Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. School for Public Health and Prim Care, Fac, Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Abstract
OBJECTIVE: To explore the need for an extended diagnostic workup in patients with venous leg ulcers (VLUs) and to establish the prevalence of the underlying causes of VLU. METHOD: This retrospective cohort study analysed data from patients with VLU. The visual analogue scale (VAS) was used for pain assessment. The ankle-brachial index (ABI) was measured to exclude patients with arterial pathology. A duplex was performed. All patients received a wound treatment plan and ambulatory compression therapy. Continuous variables were presented as mean±standard deviation (SD) or median and interquartile range (IQR). Mann-Whitney U test and Kruskal-Wallis were used. When normally distributed, an independent sample t-test was used. RESULTS: A total of 70 patients were recruited. Of these, 18 (25.7%) experienced a VLU once and 52 (74.3%) had a recurrent VLU. Treatment of the underlying lesions was performed in almost 30% of patients. Patients who were treated showed almost two times slower healing rates compared with those who were not treated for an underlying pathology. The mean time in patient referral exceeded two years, and patients who did not see their GP were treated by nurses who did not provide regular feedback the GP; as a result, compression therapy was not always adequate. CONCLUSION: Patients with a VLU showing no signs of healing after 2 months should be referred to a dedicated wound care centre to avoid delays.
OBJECTIVE: To explore the need for an extended diagnostic workup in patients with venous leg ulcers (VLUs) and to establish the prevalence of the underlying causes of VLU. METHOD: This retrospective cohort study analysed data from patients with VLU. The visual analogue scale (VAS) was used for pain assessment. The ankle-brachial index (ABI) was measured to exclude patients with arterial pathology. A duplex was performed. All patients received a wound treatment plan and ambulatory compression therapy. Continuous variables were presented as mean±standard deviation (SD) or median and interquartile range (IQR). Mann-Whitney U test and Kruskal-Wallis were used. When normally distributed, an independent sample t-test was used. RESULTS: A total of 70 patients were recruited. Of these, 18 (25.7%) experienced a VLU once and 52 (74.3%) had a recurrent VLU. Treatment of the underlying lesions was performed in almost 30% of patients. Patients who were treated showed almost two times slower healing rates compared with those who were not treated for an underlying pathology. The mean time in patient referral exceeded two years, and patients who did not see their GP were treated by nurses who did not provide regular feedback the GP; as a result, compression therapy was not always adequate. CONCLUSION:Patients with a VLU showing no signs of healing after 2 months should be referred to a dedicated wound care centre to avoid delays.
Entities:
Keywords:
chronic venous disorder; compression; diagnostic evaluation; quality of life; venous leg ulcer
Authors: Francine Heatley; Layla B Saghdaoui; Safa Salim; Sarah Onida; Manj S Gohel; Alun H Davies Journal: Phlebology Date: 2020-07-28 Impact factor: 1.740