Vascular and Endovascular Surgery Unit, 165474University of Naples Federico II, Naples, Italy.
Vascular Surgery Unit, 507855University of Campania "Luigi Vanvitelli", Medical School, Naples, Italy.
Int J Low Extrem Wounds. 2022 Dec;21(4):661-666. doi: 10.1177/15347346211010958. Epub 2021 Apr 28.
The aim of this study was to evaluate the impact of 2 lockdown periods during coronavirus disease 2019 (COVID-19) on the course and management of nonhealing vascular ulcers of lower limbs. A total of 41 patients were included in the study. Before the pandemic began they had been seen at our unit at weekly intervals. During lockdown from March 9, 2020, to May 18, 2020 subjects were not allowed to enter the hospital unless they needed urgency or emergency surgery, or oncological management. During the second lockdown, from October 19, 2020, to December 11, 2020 patients could be followed up at distance by direct outreach including telephoning contacts. Data obtained early after each lockdown were compared with those obtained prior to the pandemic. Data for the first lockdown show that pain intensified and there was an increase in the recurrence rate of wounds, of their severity, and of superimposed infections as compared with the prelockdown period. The risk of lower-limb amputation was also considerably greater. During the second and less restrictive lockdown, patients were followed up by telemedicine and data indicate that skin lesions had not worsened any further. The management of vascular wounds was impacted by the pandemic unfavorably with health care failures in the hospital as well as in the primary care settings. In conclusion, the treatment of vascular leg ulcers is challenged by the COVID-19 pandemic as this spreads worldwide. This seems to be in keeping with what happens for other diseases. The data we obtained indicate that the pandemic-related lockdown has a deleterious effect on vascular skin wounds, with an increase of severity and mortality risk. The impact appears to be proportional to the number and the degree of limitations imposed on people.
这项研究的目的是评估 2019 年冠状病毒病（COVID-19）期间两次封锁对下肢非愈合性血管溃疡的病程和治疗的影响。共有 41 例患者纳入研究。在大流行开始之前，他们每周在我们的科室接受一次治疗。在 2020 年 3 月 9 日至 5 月 18 日的封锁期间，除非患者需要紧急或急诊手术或肿瘤学治疗，否则不允许他们进入医院。在 2020 年 10 月 19 日至 12 月 11 日的第二次封锁期间，患者可以通过直接外展进行远程随访，包括打电话联系。封锁结束后早期获得的数据与大流行前获得的数据进行了比较。第一次封锁的数据显示，疼痛加剧，伤口复发率增加，其严重程度和并发感染也增加，与封锁前相比风险更高。下肢截肢的风险也明显更大。在第二次和限制较少的封锁期间，患者通过远程医疗进行了随访，数据表明皮肤病变没有进一步恶化。血管性伤口的治疗因大流行而受到不利影响，医院和初级保健机构都出现了医疗保健失败。总之，随着 COVID-19 在全球范围内的传播，血管性腿部溃疡的治疗受到了挑战。这似乎与其他疾病的情况一致。我们获得的数据表明，与大流行相关的封锁对血管性皮肤伤口有不利影响，严重程度和死亡风险增加。这种影响似乎与对人们的限制的数量和程度成正比。
