Using cluster analysis to develop a healing typology in vascular ulcers.

A clinically meaningful typology of healing was developed to assist nurses in assessing patients' healing potential. A descriptive correlational design was used to determine similarities in healing characteristics of older people with venous, venous-arterial, and arterial leg ulcers (n = 156). Hierarchical clustering techniques dendrogram using Ward's method suggested that three clusters existed based on the ankle/brachial pressure index, liposclerosis (hardening and induration of the skin of the lower limb), edema and wound characteristics: thus a healing typology was potentially formed. Nonhierarchical techniques such as analysis of variance examined cluster differences for the initial ulcer area (p < 0.013) and suggested that these groupings were reflective of differing ulcer areas. However, significant differences in the rate of healing (difference between ulcer surface area in week 4 and week 1) (measured by topographic mapping) group comparisons were not significant at the 0.05 level. Clinical differences in the healing rate were apparent, and three individual profiles of leg ulcer sufferers based on the three differing clusters of factors were outlined: rapid healers, slow healers, and nonhealers. Further research into the clustering of these factors and their application to longer healing times or time to complete healing may be significant and support the utility of this typology.