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Initial rate of healing predicts complete healing of venous ulcers.

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Fla. 33101, USA.

    , , ,

    Source

    Archives of dermatology 133:10 1997 Oct pg 1231-4

    MeSH

    Administration, Cutaneous
    Aged
    Algorithms
    Bandages
    Dermatologic Agents
    Female
    Follow-Up Studies
    Forecasting
    Humans
    Image Processing, Computer-Assisted
    Male
    Middle Aged
    Ointments
    Probability
    Prospective Studies
    Time Factors
    Treatment Outcome
    Varicose Ulcer
    Wound Healing
    Zinc Oxide

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9382561

    Citation

    Tallman, P, et al. "Initial Rate of Healing Predicts Complete Healing of Venous Ulcers." Archives of Dermatology, vol. 133, no. 10, 1997, pp. 1231-4.
    Tallman P, Muscare E, Carson P, et al. Initial rate of healing predicts complete healing of venous ulcers. Arch Dermatol. 1997;133(10):1231-4.
    Tallman, P., Muscare, E., Carson, P., Eaglstein, W. H., & Falanga, V. (1997). Initial rate of healing predicts complete healing of venous ulcers. Archives of Dermatology, 133(10), pp. 1231-4.
    Tallman P, et al. Initial Rate of Healing Predicts Complete Healing of Venous Ulcers. Arch Dermatol. 1997;133(10):1231-4. PubMed PMID: 9382561.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Initial rate of healing predicts complete healing of venous ulcers. AU - Tallman,P, AU - Muscare,E, AU - Carson,P, AU - Eaglstein,W H, AU - Falanga,V, PY - 1997/10/24/pubmed PY - 1997/10/24/medline PY - 1997/10/24/entrez SP - 1231 EP - 4 JF - Archives of dermatology JO - Arch Dermatol VL - 133 IS - 10 N2 - 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. SN - 0003-987X UR - https://www.unboundmedicine.com/medline/citation/9382561/Initial_rate_of_healing_predicts_complete_healing_of_venous_ulcers_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/vol/133/pg/1231 DB - PRIME DP - Unbound Medicine ER -