Phlebology > Volume 23, Number 3 > Pp. 130-136

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kulkarni, S R Articles by Poskitt, K R PubMed PubMed Citation Social Bookmarking                      What's this?

Original articles

Significance of limb trauma as an initiating factor in chronic leg ulceration

S R Kulkarni, M S Gohel, M R Whyman and K R Poskitt 

Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, Gloucestershire, UK

Correspondence: Mr K R Poskitt MD FRCS, Consultant Vascular Surgeon, Department of Vascular Surgery, Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire GL53 7AN, UK. Email: keith.poskitt{at}glos.nhs.uk

Objectives: To assess differences in clinical outcomes between patients with traumatic and spontaneous leg ulcers.

Methods: Consecutive leg ulcer follow-up patients seen between April 2004 and October 2005 in a specialist leg ulcer clinic were asked about the mechanism of the original ulceration. Twenty-four-week healing and 12-month recurrence rates were calculated using Kaplan-Meier analysis and outcomes were compared between groups with traumatic and spontaneous ulcers.

Results: Of the 300 patients assessed, 38 were excluded (incomplete data). In the remaining 262 patients, cause of ulceration was traumatic in 116/262 (44%) and spontaneous in 146/262 (56%). Age, ankle brachial pressure index <0.85 and venous reflux were equally distributed between groups with traumatic and spontaneous ulcers (P = 0.470, 0.793, 0.965 respectively, Chi-square test). Twenty-four-week healing rates were 81% for traumatic and 67% for spontaneous ulcers (P = 0.015, Log-Rank test). Twelve-month recurrence rates were 32% for traumatic and 33% for spontaneous ulcers (P = 0.970, Log-rank test). Patients with traumatic ulcers suffered a total of 53 ulcer recurrences (median 0, range 0–4) compared with 89 in patients with spontaneous ulcers (median 0, range 0–8) (P < 0.001, Mann-Whitney U test).

Conclusion: Approximately half of all leg ulcer patients recall a traumatic event. When managed in leg ulcer clinic, traumatic ulcers heal faster and recur less frequently than spontaneous ulcers.

Key Words: spontaneous ulcers • traumatic ulcers • ulcer healing • ulcer recurrence

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?