Vascular Surgery, Ambulatory Surgery Center, Vascular Laboratory Kennedy Hospital, Bogotá, Colombia.
General Practitioners, Ambulatory Surgery Center, Bogotá, Colombia.
Vasc Health Risk Manag. 2022 Mar 3;18:89-104. doi: 10.2147/VHRM.S345542. eCollection 2022.
Venous ulcers are the most serious complication of chronic venous insufficiency secondary to venous hypertension and represent between 80% and 90% of all ulcers vascular, having socioeconomic repercussions and on the patient's quality of life.
To determine the factors associated and complications with the morbidity of patients with venous ulcers CEAP 6 in two health delivery systems in Colombia.
Observational study retrospective multicenter carried out in two health centers, one under the subsidized scheme and the other under the contributory scheme in patients captured adults over 18 years of age during the years 2018 and 2019 with a diagnosis of chronic venous insufficiency CEAP 6 performing a review to the clinical history up to 4 years before the consultation for vascular surgery of ulcerative pathology.
A total of 105 patients were evaluated 52% of the contributory regime and 48% patients of the subsidized regime. With 139 ulcers, 70% were women. The educational level of the population in 77% of the individuals had no schooling or only had primary education. The patients of the subsidized regime belonged to the low socioeconomic stratum vs the middle-class stratum in the contributory regime. 80.5% of the lesions are concentrated in groups less than 25 cm and 19.4% of the cases are located above 50 cm. Dressings and advanced technologies were used in 30.02% of the patients in the contributory scheme compared to 24.35% in the subsidized scheme. 37% of the subsidized scheme had contagion vs 28% of the contributory scheme. The epithelialization rates were 67.27% in the contributory regime compared to 26% in the subsidized regime.
The prognostic factors that favor wound epithelialization are related to ulcers smaller than 25 cm, lesion evolution time under 36 months, having been managed with dressings and other advanced technologies, and belonging to the contributory regime.
静脉溃疡是静脉高压引起的慢性静脉功能不全的最严重并发症,占所有血管性溃疡的 80%至 90%,具有社会经济影响和对患者生活质量的影响。
在哥伦比亚的两个卫生服务系统中,确定与静脉溃疡 CEAP 6 患者发病率相关的因素和并发症。
这是一项在两个卫生中心进行的观察性、回顾性、多中心研究,一个是在补贴计划下,另一个是在缴费计划下,在 2018 年和 2019 年期间,对年龄在 18 岁以上的患有慢性静脉功能不全 CEAP 6 的成年患者进行了回顾性分析,对溃疡性病理血管手术前 4 年的临床病史进行了回顾。
共评估了 105 名患者,其中 52%来自缴费计划,48%来自补贴计划。共有 139 个溃疡,其中 70%为女性。人群的教育水平在 77%的个体中没有受过教育或只有小学教育。补贴计划的患者属于社会经济地位较低的阶层,而缴费计划的患者则属于中产阶级阶层。80.5%的病变集中在小于 25cm 的组,19.4%的病例位于 50cm 以上。与补贴计划相比,在缴费计划中,30.02%的患者使用了敷料和先进技术,而在补贴计划中,这一比例为 24.35%。在补贴计划中,37%的患者发生感染,而缴费计划中这一比例为 28%。缴费计划的上皮化率为 67.27%,而补贴计划为 26%。
有利于创面上皮化的预后因素与小于 25cm 的溃疡、小于 36 个月的病变演变时间、使用敷料和其他先进技术治疗以及属于缴费计划有关。