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Critical Evaluation of Delayed Healing of Venous Leg Ulcers: A Retrospective Analysis in Canadian Patients

  • Original Research Article
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American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

Venous leg ulcers (VLUs) are common but challenging health problems. Better understanding of the risk factors involved in delayed healing of VLUs may therefore guide individualized treatment plans to improve patient outcomes.

Objective

We sought to identify the risk factors associated with delayed healing of VLUs in patients seen at a tertiary academic wound care clinic.

Methods

A retrospective analysis of 554 patients who presented to the Toronto Regional Wound Healing Clinic for VLUs in a 3-year period was performed. Patient and ulcer characteristics were recorded. Multivariate analyses were performed to compare patients with ulcer resolution and those whose ulcers did not resolve after 12-month follow-up.

Results

The average age of the patients was 67.3 ± 0.7 years, with 56 % being female. The most common comorbidities were hypertension (54 %), dyslipidemia (33 %), a history of smoking (30 %), and diabetes (26 %). Ulcer resolution was associated with a smaller ulcer size (odds ratio [OR] 0.984 [95 % confidence interval (CI) 0.973, 0.996]), shorter ulcer duration (OR 0.704 [95 % CI 0.574, 0.865]), and dyslipidemia (OR 1.848 [95 % CI 1.052, 3.246]).

Conclusion

Pro-healing factors associated with VLUs were a smaller ulcer size and a shorter ulcer duration. Dyslipidemia was also associated with improved healing, potentially owing to the use of statins. Patients presenting with poorer-prognosis VLUs should receive more aggressive treatment with earlier referral to vascular surgery.

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Authors and Affiliations

  1. Division of Vascular Surgery, University of Toronto, Toronto, ON, Canada

    Gary K. Yang, Ahmed Kayssi & Andrew D. Dueck

  2. Division of Dermatology, Department of Medicine, Women’s College Hospital, University of Toronto, 5th Floor, 76 Grenville Street, Toronto, ON, M5S1B2, Canada

    Sarah Cao & Afsaneh Alavi

Authors
  1. Gary K. Yang
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  2. Sarah Cao
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  3. Ahmed Kayssi
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Corresponding author

Correspondence to Afsaneh Alavi.

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Disclosures

The findings of this study were presented at the 2015 Canadian Society of Vascular Surgery Meeting in Victoria, BC, Canada (September 26, 2015).

Conflicts of Interest

The authors (Gary K. Yang, Sarah Cao, Ahmed Kayssi, Andrew D. Dueck, and Afsaneh Alavi) declare that they have no conflicts of interest that are directly relevant to the content of this article.

Funding

No funding was received to conduct this study.

Ethical Approval

The study was approved by the Research Ethics Board at Women’s College Hospital (Toronto, ON, Canada).

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Yang, G.K., Cao, S., Kayssi, A. et al. Critical Evaluation of Delayed Healing of Venous Leg Ulcers: A Retrospective Analysis in Canadian Patients. Am J Clin Dermatol 17, 539–544 (2016). https://doi.org/10.1007/s40257-016-0214-4

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  • DOI: https://doi.org/10.1007/s40257-016-0214-4

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