FULL-THICKNESS LEG ULCERS - PATIENT DEMOGRAPHICS AND PREDICTORS OF HEALING

Background. Despite increased knowledge about the immediate and underl ying causes of chronic leg ulcers, their management remains a challeng e. Some ulcers rapidly respond to treatment whereas others do not, and the decision to reassess the patient and treatment modality is usuall y based on the clinician's own experience. Methods. Following diagnosi s of the underlying cause of leg ulcers, 181 patients were screened. T he use of a hydrocolloid dressing (DuoDERM) was evaluated in the treat ment of 61 patients with 72 full-thickness ulcers. Patient characteris tics associated with deep wounds as well as patient and wound characte ristics predictive of the extent of healing and time required for heal ing were identified. Results. Patients with full-thickness ulcers were more likely to be overweight (P < .001) and not fully mobile (P = .01 6). During a mean treatment time of 56 days, 54% of the full-thickness ulcers healed. Ulcers were less likely to heal if the patients were m en (P = .02) or had diabetes mellitus (P < .003). A >30% reduction in ulcer area after 2 weeks of treatment was a predictor of both treatmen t outcome (P = .016) and time required for healing (P = .004). Odor at baseline and advanced age also were associated with increased time re quired for healing (P = .005 and .017, respectively). Conclusions. Non invasive clinical assessments can aid the clinician in predicting trea tment outcome and may facilitate the decision to change therapy and ev aluate treatment compliance.