Chronic cutaneous ulcers: etiology and epidemiology.

The most commonly encountered chronic cutaneous ulcers in the United States are pressure ulcers and leg ulcers; this review is limited to the epidemiology of these ulcers. Chronic leg ulcers are frequently encountered in clinical practice but the extent of the problem is largely unknown. In particular, epidemiologic information within the United States is sadly lacking. Although there are more data available regarding the incidence and prevalence of pressure ulcers in acute and chronic care facilities, national surveys should be considered to obtain more accurate information on their incidence and prevalence. Multicenter studies are necessary to determine the epidemiology and cost of treating pressure ulcers by stage, setting, and other factors. Particular attention should be paid to high-risk groups such as spinal cord injury patients, the elderly, and those who are immobilized or chronically debilitated. Leg ulcers and pressure ulcers probably account for the majority of chronic cutaneous ulcers seen in the United States.