Venous and non-venous leg ulcers: Clinical history and appearance in a population study

Abstract

In a defined Swedish population of 270,800, all patients with current chronic leg ulcers (827) were identified and a random sample of 382 studied in detail. Ulcers of primarily venous cause comprised 54 per cent of the total, giving a point prevalence of 0.16 per cent (95 per cent confidence interval 0.15-0.18 per cent). Half of all patients experienced their first ulcer episode before the age of 65 years, a greater proportion (61 per cent, P < 0.0001) in the subgroup with venous ulcers. The median duration of ulcer diathesis was significantly longer in patients with venous than in those with non-venous lesions (13.4 versus 2.5 years, P < 0.001). About half the patients with venous and non-venous ulcers had had their current lesion for longer than 1 year. Venous ulcers were more often recurrent than those of non-venous type (72 versus 45 per cent of patients, P < 0.0001). Patients with venous ulcers had a significantly higher body mass index (P < 0.001). The number of dressing changes performed per week was 1100 per 100,000 population. The predictive value of 'classical' clinical indicators of venous ulcer did not exceed 0.76. To increase the accuracy of diagnosis of venous ulcer, clinical examination should be combined with non-invasive 'objective' haemodynamic assessment of the venous circulation.

A Systematic Review and Meta-analysis of Exercise Intervention for the Treatment of Calf Muscle Pump Impairment in Individuals with Chronic Venous Insufficiency

“…Sixty to 80% of leg ulcers have a venous component. [1][2][3][4][5][6][7] The Lothian and Forth Valley Study examined 600 patients with leg ulceration and found that 76% of ulcerated legs had evidence of venous disease and 22% had evidence of arterial disease. Ten to 20% of cases had both arterial and venous insufficiency.…”

“…8 Chronic venous leg ulceration has an estimated prevalence of between 0.1% and 0.3% in the United Kingdom. [1][2][3][4][5][6]9 Prevalence increases with age. 8 Approximately 1% of the population will suffer from leg ulceration at some point in their lives.…”

Association Between Microbial Bioburden and Healing Outcomes in Venous Leg Ulcers: A Review of the Evidence

“…1,2 Among people aged 65 years and older, the annual prevalence of VLUs is 1.7%. 3 Of all types of chronic ulcers, VLUs have the worst long-term healing prognosis and are more likely to be recurrent.…”

“…3 Of all types of chronic ulcers, VLUs have the worst long-term healing prognosis and are more likely to be recurrent. 2,4 In fact, half of the patients diagnosed with VLUs have an ulcer duration greater than 1 year and recurrence has been estimated at > 75% of those affected. 1,2 With such long ulcer duration and high recurrence rate, patients presenting for wound care can be at any point along this continuum, and often have an extensive medical history with several comorbidities and complex medication regimens.…”

“…1,2,14,17,18 Most studies of VLU microbial bioburden either exclude or do not account for these characteristics, making deduction of significant patterns difficult. In this review, we will examine the studies of microbial bioburden in VLUs that have included information on patient wound parameters and outcomes, with the goal of guiding future studies to improve the objective assessment of bacterial infection and clarify the role of antimicrobial treatment in VLUs.…”