Department of Dermatology, Hôpital Sud, University of Amiens, 80054, Amiens, France.
Br J Dermatol. 2013 Nov;169(5):1106-13. doi: 10.1111/bjd.12570.
Some prognostic markers of venous leg ulcer (VLU) healing have been evaluated, mostly in retrospective studies.
To identify which clinical characteristics, among those known as possible prognostic factors of VLU healing, and which VLU-associated sociodemographic and psychological factors, are associated with complete healing at week 24 (W24).
A prospective, multicentre, cohort study was conducted in 22 French dermatology departments between September 2003 and December 2007. The end point was comparison between healed and nonhealed VLUs at W24, for patient clinical and biological characteristics; psychological, cognitive and social assessments; affected leg inclusion characteristics; venous insufficiency treatment and percentage of initial wound area reduction during follow-up.
In total, 104 VLUs in 104 patients were included; 94 were analysed. The mean VLU area and duration were 36.8 ± 55.5 cm2 and 24.8 ± 45.7 months, respectively. At W24, 41/94 VLUs were healed. Univariate analysis significantly associated complete healing with superficial venous surgery (P = 0.001), adherence to compression therapy at W4 (P = 0.03) and W24 (P = 0.01), ankle-joint ankylosis (P = 0.01) and mean percentage of VLU area reduction at W4 (P = 0.04). Multivariate analysis retained superficial venous surgery during follow-up [odds ratio (OR) 8.4, 95% confidence interval (CI) 1.9-48.2] and percentage reduction of the VLU area at W4 (OR 1.6, 95% CI 1.0-2.14) as being independently associated with healing.
These results indicate that complete healing of long-standing, large VLUs is independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.
一些静脉性腿部溃疡（VLU）愈合的预后标志物已经得到了评估，其中大多数是在回顾性研究中。
确定在已知的 VLU 愈合的可能预后因素中，哪些临床特征以及与 VLU 相关的社会人口统计学和心理因素与 24 周（W24）时的完全愈合相关。
2003 年 9 月至 2007 年 12 月期间，在法国 22 个皮肤科部门进行了一项前瞻性、多中心、队列研究。研究终点是比较 24 周时愈合和未愈合的 VLU，比较患者的临床和生物学特征；心理、认知和社会评估；受影响腿部的纳入特征；静脉功能不全的治疗以及随访期间初始伤口面积减少的百分比。
共纳入 104 例患者的 104 个 VLU，其中 94 个进行了分析。VLU 的平均面积和持续时间分别为 36.8 ± 55.5cm2和 24.8 ± 45.7 个月。在 24 周时，94 个 VLU 中有 41 个愈合。单因素分析显示，浅表静脉手术（P = 0.001）、第 4 周（P = 0.03）和第 24 周（P = 0.01）时对压缩治疗的依从性、踝关节强直（P = 0.01）以及 VLU 面积在第 4 周的平均减少百分比（P = 0.04）与完全愈合显著相关。多因素分析保留了随访期间的浅表静脉手术[比值比（OR）8.4，95%置信区间（CI）1.9-48.2]和第 4 周 VLU 面积减少百分比（OR 1.6，95%CI 1.0-2.14）与愈合独立相关。
这些结果表明，长期、大 VLU 的完全愈合与失能浅表静脉的消融以及治疗后第 4 周的伤口面积减少百分比独立相关。
