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Predicting time to healing by anatomical assessment of venous pathology

Maria Teresa Szewczyk, Arkadiusz Jawien, Arkadiusz Migdalski, Radoslaw Piotrowicz, Tomasz Grzela, Pawel Brazis

Med Sci Monit 2009; 15(2): CR74-81

ID: 869558

Available online: 2009-01-29

Published: 2009-01-29

Background: The aim of the study was to assess the clinical effectiveness of multilayer compression in aspect of anatomical site of venous pathology and ulcers.
Material and Method: The study was conducted between 2000 and 2006 among 112 patients with 121 ulcers treated in the Venous Ulcer Outpatient Clinic of the Chair and Clinic of Surgery, Biziel Hospital in Bydgoszcz, Poland. Patients between 31 and 89 years old (mean age - 63.6 years, median 65) were randomized into two groups treated with two- and four-layer compression system. Healing process dynamics were assessed by planimetry. Maximum period of observation was 48 weeks.
Results: The longest mean time of ulcer healing and the highest values of cumulated indicator of unhealed ulcers were observed among patients with simultaneous insufficiency of two venous systems - superficial and deep (p=0.0034, test log-rank) and among patients with insufficiency of deep, superficial and perforating venous system (p=0.0001, test log-rank). Significantly longer mean healing time was characteristic for localization on the back calf region (p=0.01, test log-rank). Dynamics of healing of ulcers treated by two- and four-layer systems were compared.
Conclusions: Anatomical localization of venous pathology and ulcer localization were found as important prognostic factors; longer healing time and lower probability of healing was observed among patients with deep venous insufficiency and when the ulcer was localized in the atypical back calf region. No differences of healing time between groups in aspect of used system were showed.

Keywords: Varicose Ulcer - therapy, Wound Healing, Time Factors, Kaplan-Meier Estimate, Intermittent Pneumatic Compression Devices, Aged, 80 and over, Adult