Tallman P, Muscare E, Carson P, Eaglstein WH, Falanga V, et al.
Archives of dermatology. Date of publication 1997 Oct 1;volume 133(10):1231-4.
1. Arch Dermatol. 1997 Oct;133(10):1231-4.
Initial rate of healing predicts complete healing of venous ulcers.
Tallman P(1), Muscare E, Carson P, Eaglstein WH, Falanga V.
Author information:
(1)Department of Dermatology and Cutaneous Surgery, University of Miami School of
Medicine, Fla. 33101, USA.
BACKGROUND: Venous ulcers represent a clinical problem with considerable
morbidity, especially in the elderly population. Standard treatment is the use of
leg compression bandages to improve the underlying venous hypertension, but not
every ulcer heals in a timely fashion with this treatment modality. Methods are
needed to predict the outcome of standard treatment as soon as possible to
institute alternative therapy.
OBJECTIVE: To prospectively study the rate of healing in a group of elderly
patients with venous ulcers, based on a previously described equation that takes
into account the size and perimeter of the ulcer.
METHODS: We studied by computerized planimetry 15 elderly patients with venous
ulcers treated with leg compression bandages for up to 24 weeks or until complete
healing. We determined weekly healing rate by comparing ulcer size at each visit
to initial baseline size (baseline-adjusted healing rate). Also, we used a novel
way to calculate the healing rate at a given week by taking the mean of all
previous healing rates between each visit (mean-adjusted healing rate).
RESULTS: When using the baseline-adjusted healing rate, we noted what we describe
as a healing rate instability from week to week, which decreases the ability to
predict complete healing. However, the mean-adjusted healing rate allowed us to
predict complete healing as early as 3 weeks from starting therapy (P<.001).
CONCLUSION: In this prospective study of elderly patients with venous ulcers, we
describe a novel and more powerful method for predicting complete healing of
venous ulcers with compression therapy alone.
PMID: 9382561 [Indexed for MEDLINE]
