HEALING RATE AND BACTERIAL NECROTIZING VASCULITIS IN VENOUS LEG ULCERS

Morbidity associated with venous leg ulcers is important in the elderl y. The biological processes involved during attempts at healing are mu ch more complex than in most models of experimental wounds. In additio n, there is still controversy on deleterious effects elicited by both microorganisms and antiseptics on cells involved in the healing proces s. Using histology, immunohistochemistry and iterative computerized pl animetry, we evaluated the bacterial load, the inflammatory aspects an d the healing rate of leg ulcers present in 15 eligible women aged fro m 57 to 73 years. Each patient had at least 2 chronic ulcers treated w ith hydrocolloid dressing alone or in combination with daily applicati ons of povidone-iodine solution (PVP-I). The weekly reduction in wound area was superior for hydrocolloid + PVP-I treatment than in hydrocol loid-treated ulcers. After a 4-week treatment, hydrocolloid-treated ul cers contained clumps of microorganisms and showed massive infiltratio n by phagocytes including Mac 387+ and factor XIIIa+ cells. Leukocytoc lastic vasculitis was present as well. These features were less pronou nced in ulcers treated with hydrocolloid + PVP-I. In sum, a broad-spec trum antimicrobial such as PVP-I may be beneficial in reducing deleter ious bacteria-related inflammation. As a result, the healing rate leg ulcers is enhanced.