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The Impact of Skin Grafting on the Quality of Life and Self-Esteem of Patients with Venous Leg Ulcers

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Abstract

Background

The assessment of health-related quality of life in patients with venous leg ulcers provides important information for clinical decision making, evaluation of therapeutic benefits, and prediction of survival probabilities.

Methods

Health-related quality of life and self-esteem were assessed using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Rosenberg self-esteem (RSE) scale, respectively, in patients with venous leg ulcers treated with split-thickness skin grafts. One hundred patients with venous leg ulcers and indication for skin grafting were divided into two groups of 50 patients each: the control group (patients who received conservative treatment) and surgery group (patients who received split-thickness skin grafts).

Results

Patients in the surgery group reported significantly higher SF-36 scores (better health status) than controls one month after surgery, as well as 90 and 180 days postoperatively (p < 0.002). The mean total RSE score was significantly lower (indicating higher self-esteem) in the surgery group (mean RSE score, 17.54) than in the control group (mean RSE score, 24.22).

Conclusions

Split-thickness skin grafting resulted in better health-related quality of life and self-esteem in patients with venous leg ulcers than did compression therapy with Unna’s boot.

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References

  1. Salomé GM, Espósito VH (2008) Nursing students experiences while caring people with wounds. Rev Bras Enferm 61:822–827

    Article  PubMed  Google Scholar 

  2. Worley CA (2006) It hurts when I walk: venous stasis disease–differential diagnosis and treatment. Dermatol Nurs 18:582–583

    PubMed  Google Scholar 

  3. Carr SC (2008) Diagnosis and management of venous ulcers. Perspect Vasc Surg Endovas Ther 20:82–85

    Article  Google Scholar 

  4. Borges EL, Caliri MH, Haas VJ (2007) Systematic review of topic treatment for venous ulcers. Rev Lat Am Enfermagem 15:1163–1170

    PubMed  Google Scholar 

  5. Nelson EA (2010) Compression therapy, dressings and topical agents for venous ulcer healing. Phlebology 25(1 Suppl):28–34

    Article  PubMed  Google Scholar 

  6. Escaleira R, Cardoso M, Rego J et al (2010) Efficacy of a two component compression system for the therapy of venous leg ulcers. J Wound Care 19:104–109

    CAS  PubMed  Google Scholar 

  7. Salgado MI, Pestroianu A, Burgarelli GL et al (2007) Conducted healing and skin graft for the treatment of skin wounds. Rev Assoc Med Bras 53:80–84

    Article  PubMed  Google Scholar 

  8. Hubbard M (2010) Managing skin grafts and donor sites. Ostomy Wound Manag 56:8

    Google Scholar 

  9. Rahman GA, Adigun IA, Fadeyi A (2010) Epidemiology, etiology, and treatment of chronic leg ulcer: experience with sixty patients. Ann Afr Med 9:1–4

    Article  CAS  PubMed  Google Scholar 

  10. Green J, Jester R (2010) Health-related quality of life and chronic venous leg ulceration: Part 2. Br J Commun Nurs 15:S4–S6

    Google Scholar 

  11. Ciconelli RM, Ferraz MB, Santos W, Meinão I et al (1999) Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Rev Bras Reumatol 39:143–150

    Google Scholar 

  12. Dini GM, Quaresma MR, Ferreira LM (2004) Translation into Portuguese, cultural adaptation and validation of the Rosenberg self-esteem scale. Rev Soc Bras Cir Plast 19:41–52

    Google Scholar 

  13. de Gouveia Santos VL, Sellmer D, Massulo MM (2007) Inter-rater reliability of pressure ulcer scale for healing (PUSH) in patients with chronic leg ulcers. Rev Lat Am Enfermagem 15:391–396

    Article  PubMed  Google Scholar 

  14. Santos VL, Azevedo MA, Silva TS et al (2005) Crosscultural adaptation of the pressure ulcer scale for healing to the Portuguese language. Rev Lat Am Enfermagem 13:305–313

    PubMed  Google Scholar 

  15. Thomas DR, Rodeheaver GT, Bartolucci AA et al (1997) Pressure ulcer scale for healing: derivation and validation of the PUSH tool. The PUSH Task Force. Adv Wound Care 10:96–101

    CAS  PubMed  Google Scholar 

  16. Salomé GM, Pellegrino DMS, Vieira TF et al (2012) Sleep quality among patients with venous ulcers: a cross-sectional study in a health care setting in São Paulo, Brazil. Wounds 24:124–131

    Google Scholar 

  17. Milic DJ, Zivic SS, Bogdanovic DC et al (2007) A randomized trial of the Tubulcus multilayer bandaging system in the treatment of extensive venous ulcers. J Vasc Surg 46:750–755

    Article  PubMed  Google Scholar 

  18. Palfreyman S (2008) Assessing the impact of venous ulceration on quality of life. Nurs Times 104:34–37

    PubMed  Google Scholar 

  19. Renner R, Gebhardt C, Simon JC et al (2009) Changes in quality of life for patients with chronic venous insufficiency, present or healed leg ulcers. J Dtsch Dermatol Ges 7:953–961

    PubMed  Google Scholar 

  20. Reich-Schupke S, Murmann F, Altmeyer P et al (2009) Quality of life and patients’ view of compression therapy. Int Angiol 28:385–393

    CAS  PubMed  Google Scholar 

  21. Frade MAC, Soares SC, Foss NT et al (2005) Leg ulcer: an observational study in Juiz de Fora, MG (Brazil) and region. An Bras Dermatol 80:41–46

    Google Scholar 

  22. Bergonse FN, Rivitti EA (2006) Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers. An Bras Dermatol 81:131–135

    Google Scholar 

  23. Thomsen T, Tønnesen H, Møller AM (2009) Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation. Br J Surg 96:451–461

    Article  CAS  PubMed  Google Scholar 

  24. Kean J (2010) The effects of smoking on the wound healing process. J Wound Care 19:5–8

    CAS  PubMed  Google Scholar 

  25. Lindström D, Wladis A, Pekkari K (2010) The thioredoxin and glutaredoxin systems in smoking cessation and the possible relation to postoperative wound complications. Wounds 4:88–93

    Google Scholar 

  26. Jones JE, Robinson J, Barr W et al (2008) Impact of exudate and odour from chronic venous leg ulceration. Nurs Stand 22:53–54

    Article  CAS  PubMed  Google Scholar 

  27. Blomgren L, Johansson G, Bergqvist D (2006) Quality of life after surgery for varicose veins and the impact of preoperative duplex: results based on a randomized trial. Ann Vasc Surg 20:30–34

    Article  PubMed  Google Scholar 

  28. Jankunas V, Bagdonas R, Samsanavicius D et al (2007) An analysis of the effectiveness of skin grafting to treat chronic venous leg ulcers. Wounds 5:128–137

    Google Scholar 

  29. Salomé GM, Blanes L, Ferreira LM (2009) Functional capability of patients with diabetes with foot ulceration. Acta Paul Enferm 22:412–416

    Article  Google Scholar 

  30. Salomé GM, Ferreira LM (2013) Impact of skin grafting of venous leg ulcers on functional status and pain. World J Surg 37:1438–1445. doi:10.1007/s00268-013-1975-z

    Article  PubMed  Google Scholar 

  31. Collier M, Hollinworth H (2000) Pain and tissue trauma during dressing change. Nurs Stand 14:71–73

    Article  CAS  PubMed  Google Scholar 

  32. Guarnera G, Tinelli G, Abeni D et al (2007) Pain and quality of life in patients with vascular leg ulcers: an Italian multicentre study. J Wound Care 16:347–351

    CAS  PubMed  Google Scholar 

  33. Persoon A, Heinen MM, van der Vleuten CJ et al (2004) Leg ulcers: a review of their impact on daily life. J Clin Nurs 13:341–354

    Article  PubMed  Google Scholar 

  34. Finlayson K, Edwards H, Courtney M (2010) The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers. J Clin Nurs 19:1289–1297

    Article  PubMed  Google Scholar 

  35. Avanci JQ, Assis SG, Santos NC et al (2007) Cross-cultural adaptation of self-esteem scale for adolescents. Psicol Reflex Crit 20:397–405

    Article  Google Scholar 

  36. Salome GM, Ferreira LM (2012) Quality of life in patients with venous ulcers treated with Unna’s boot compressive therapy. Rev Bras Cir Plast 27:466–471

    Article  Google Scholar 

  37. Koupidis SA, Paraskevas KI, Stathopoulos V et al (2008) Impact of lower extremity venous ulcers due to chronic venous insufficiency on quality of life. Open Cardiovasc Med J 2:105–109

    Article  PubMed Central  PubMed  Google Scholar 

  38. Henderson EA (2006) Are theories of altered body image applicable to patients with chronic wounds? J Wound Care 15:58–60

    CAS  PubMed  Google Scholar 

  39. Salomé GM, de Souza Maria, Pellegrino D, Blanes L et al (2011) Self-esteem in patients with diabetes mellitus and foot ulcers. J Tissue Viability 20:100–106

    Article  PubMed  Google Scholar 

  40. Salomé GM, Blanes L, Ferreira LM (2011) Assessment of depressive symptoms in people with diabetes mellitus and foot ulcers. Rev Col Bras Cir 38:327–333

    Article  PubMed  Google Scholar 

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Conflict of interest

There was no external funding for this study. The authors have no conflict of interest, financial interest, or commercial association with any of the subject matter or products mentioned in the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Sapucaí Valley University (UNIVÁS), Pouso Alegre, Minas Gerais, Brazil

    Geraldo M. Salomé

  2. Division of Plastic Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

    Leila Blanes & Lydia M. Ferreira

  3. Av. Francisco de Paula Quintanilha Ribeiro 280, apt.134, Jabaguara, São Paulo, SP, CEP 04330-020, Brazil

    Geraldo M. Salomé

Authors
  1. Geraldo M. Salomé
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  2. Leila Blanes
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  3. Lydia M. Ferreira
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Corresponding author

Correspondence to Geraldo M. Salomé.

Additional information

A study developed in the Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

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Salomé, G.M., Blanes, L. & Ferreira, L.M. The Impact of Skin Grafting on the Quality of Life and Self-Esteem of Patients with Venous Leg Ulcers. World J Surg 38, 233–240 (2014). https://doi.org/10.1007/s00268-013-2228-x

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  • DOI: https://doi.org/10.1007/s00268-013-2228-x

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