Clinical Services, ConvaTec Medical Care Brazil, Sao Paulo, São Paulo, Brazil.
Graduate Program in Adult Health Nursing, University of São Paulo School of Nursing (Universidade de Sao Paulo, Escola de Enfermagem-EEUSP), Sao Paulo, Sao Paulo, Brazil.
Int J Low Extrem Wounds. 2024 Sep;23(3):455-463. doi: 10.1177/15347346211065929. Epub 2022 Jan 4.
The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.
静脉溃疡的复发是指先前溃疡在经历一段上皮化完成期后，由于暴露于致病因素和缺乏预防措施而再次开放。静脉溃疡的复发率很高，且可能随着时间的推移而增加。由于门诊患者的随访和治愈后的治疗依从性不足，因此关于其发病率和危险因素的流行病学证据有限。本研究旨在分析门诊静脉溃疡复发的发生率及其发生的危险因素。这是一项回顾性观察性队列研究，通过电子病历进行数据收集。研究地点为私人健康保险门诊。参与者为患有愈合性静脉溃疡的成年患者。从 2014 年和 2018 年开始计算愈合性溃疡患者的静脉溃疡复发率，随访时间至少为一年。采用单变量分析和逻辑回归分析探讨了考虑人口统计学、临床和伤口相关变量的危险因素。结果，在 134 例愈合性静脉溃疡患者中，有 65 例（65/134，48.5%）发生了溃疡复发，平均复发时间为 230.1（SD 267）天。复发静脉溃疡患者主要为女性（39/48.1%），平均年龄为 64（SD 15.5）岁，57 例（50.8%）合并有某种合并症，其中最常见的是系统性动脉高血压（47/51%）。肥胖（15/88.2%）使静脉溃疡复发的风险增加 8.7 倍（OR 95%CI 2.1-60.8； = .009）。结论，静脉溃疡的复发率为 48.5%，肥胖是一个危险因素。本研究表明，当伤口愈合后，对静脉溃疡患者的临床处理不应结束。为了预防溃疡复发，除了对伤口进行局部处理外，还需要针对系统性因素进行干预。
