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Epidemiology of Wounds

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Measurements in Wound Healing

Abstract

Chronic wounds of the lower extremities are important health concerns that have been estimated to cost more than $1 billion per year. Their prevalence has been estimated to be between 0.18% and 1.3% in the adult population. Venous leg ulcers are the most common lower extremity wound. Diabetic foot ulcers are less common but are associated with significant morbidity and with mortality. For example, lower extremity amputations in those with diabetes are often preceded by a foot ulcer and between 10% and 20% of those with diabetes who have an amputation will die within 1 year of the amputation. Continued Improvement in therapy is essentially especially as the population ages and the prevalence of diabetes increases.

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References

  1. Bickers DR, Lim HW, Margolis D, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55:490–500.

    Article  PubMed  Google Scholar 

  2. Coon WW, Willis 3rd PW, Keller JB. Venous thromboembolism and other venous disease in the Tecumseh community health study. Circulation. 1973;48:839–46.

    Article  PubMed  CAS  Google Scholar 

  3. Sell S. The role of progenitor cells in repair of liver injury and in liver transplantation. Wound Repair Regen. 2001;9:467–82.

    Article  PubMed  CAS  Google Scholar 

  4. Hallbook T. Leg ulcer epidemiology. Acta Chir Scand. 1988;544:17–20.

    CAS  Google Scholar 

  5. Ashkenazy R, Abrahamsom MJ. Medicare coverage for patients with diabetes. A national plan with individual consequences. J Gen Intern Med. 2006 Apr;21(4):386-92. From PubMed.

    Article  PubMed  CAS  Google Scholar 

  6. Phillips TJ. Chronic cutaneous ulcers: etiology and epidemiology. J Invest Dermatol. 1994;102:38S–41.

    Article  PubMed  CAS  Google Scholar 

  7. Lees TA, Lambert D. Prevalence of lower limb ulceration in an urban health district. Br J Surg. 1992;79:1032–4.

    Article  PubMed  CAS  Google Scholar 

  8. Lindholm C, Bjellerup M, Christensen OB, Zederfeldt B. A demographic survey of leg and foot ulcer patients in a defined population. Acta Derm Venereol. 1992;72(3):227–30.

    PubMed  CAS  Google Scholar 

  9. Mostow EN. Diagnosis and classification of chronic wounds. Clin Dermatol. 1994;12:3–11.

    Article  PubMed  CAS  Google Scholar 

  10. Baker SR, Stacey MC, Singh G, Hoskin SE, Thompson PJ. Aetiology of chronic leg ulcers. Eur J Vasc Surg. 1992;6(3):245–51.

    Article  PubMed  CAS  Google Scholar 

  11. Falanga V, Kirsner R, Katz MH, Gould E, Eaglstein WH, McFalls S. Pericapillary fibrin cuffs in venous ulceration: persistence with treatment and during ulcer healing. J Dermatol Surg Oncol. 1993;18:409–14.

    Google Scholar 

  12. Criqui MH, Jamosmos M, Fronek A, et al. Chronic venous disease in an ethnically diverse population: the San Diego population study. Am J Epidemiol. 2003;158:448–56.

    Article  PubMed  Google Scholar 

  13. Nelzen O, Bergqvist D, Lindhagen A, Hallbook T. Chronic leg ulcers: an underestimated problem in primary health care among elderly patients. J Epidemiol Community Health. 1991;45:184–7.

    Article  PubMed  CAS  Google Scholar 

  14. Franks PJ, Wright DD, Moffatt CJ, et al. Prevalence of venous disease: a community study in west London. Eur J Surg. 1992;158:143–7.

    PubMed  CAS  Google Scholar 

  15. Margolis DJ, Berlin JA, Strom BL. Which venous leg ulcers will heal with a limb compression bandage? Am J Med. 2000;109:15–9.

    Article  PubMed  CAS  Google Scholar 

  16. Margolis DJ, Bilker W, Santanna J, Baumgarten M. Venous leg ulcer: incidence and prevalence in the elderly. J Am Acad Dermatol. 2002;46:381–6.

    Article  PubMed  Google Scholar 

  17. Abbade LPF, Lastoria S. Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Int J Dermatol. 2005;44:449–56.

    Article  PubMed  Google Scholar 

  18. Valencia IC, Falabella A, Kirsner RS, Eaglstein WH. Chronic venous insufficiency and venous leg ulceration. J Am Acad Dermatol. 2001;44:401–21.

    Article  PubMed  CAS  Google Scholar 

  19. Margolis DJ, Knauss J, Bilker W. Medical conditions associated with venous leg ulcers in an outpatient. Br J Dermatol. 2004;150:267–73.

    Article  PubMed  CAS  Google Scholar 

  20. Phillips T, Stanton B, Provan A, Lew R. A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications. J Am Acad Dermatol. 1994;31:49–53.

    Article  PubMed  CAS  Google Scholar 

  21. Noguerira GS, Zanin CR, Miyazaki MCOS, de Godoy JMR. Venous leg ulcers and emotional consequences. Int J Low Extrem Wounds. 2009;8:194–6.

    Article  Google Scholar 

  22. Price PE, Harding K. Acute and chronic wounds: differences in self-reported health-related quality of life. J Wound Care. 2000;9:93–5.

    PubMed  CAS  Google Scholar 

  23. Jull A, Walker N, Hackett M, et al. Leg ulceration and perceived health: a population based case–control study. Age Ageing. 2004;33:236–41.

    Article  PubMed  Google Scholar 

  24. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. [see comment]. Diabetes Care. 2004;27:1047–53.

    Article  PubMed  Google Scholar 

  25. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290:1884–90.

    Article  PubMed  CAS  Google Scholar 

  26. Honeycutt AA, Boyle JP, Broglio KR, et al. A dynamic Markov model for forecasting diabetes prevalence in the United States through 2050. Health Care Manag Sci. 2003;6:155–64.

    Article  PubMed  Google Scholar 

  27. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. [see comment]. Diabetes Care. 1998;21:1414–31.

    Article  PubMed  CAS  Google Scholar 

  28. Margolis D, Malay DS, Hoffstad OJ, et al. Prevalence of diabetes, diabetic foot ulcer, and lower extremity amputation among Medicare beneficiaries, 2006 to 2008. Rockville: Agency for Healthcare Research and Quality; 2010.

    Google Scholar 

  29. Boulton AJ, Malik RA. Diabetic neuropathy. Med Clin North Am. 1998;82:909–29.

    Article  PubMed  CAS  Google Scholar 

  30. Boulton AJ, Boulton AJM. The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab Res Rev. 2008;24 Suppl 1:S3–6.

    Article  PubMed  Google Scholar 

  31. Boulton AJM, Gries FA, Jervell JA. Guidelines for the diagnosis and outpatient management of diabetic peripheral neuropathy. Diabetes Rev. 1999;7:237–44.

    Google Scholar 

  32. Wrobel JS, Mayfield JA, Reiber GE. Geographic variation of lower-extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care. 2001;24:860–4.

    Article  PubMed  CAS  Google Scholar 

  33. Mayfield JA, Reiber GE, Maynard C, Czerniecki J, Sangeorzan B. The epidemiology of lower-extremity disease in veterans with diabetes. Diabetes Care. 2004;27 Suppl 2:B39–44.

    Article  PubMed  Google Scholar 

  34. Reiber GE, Vileikyte L, Boyko EJ, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care. 1999;22:157–62.

    Article  PubMed  CAS  Google Scholar 

  35. Reiber GE, MeMaster JW. Epidemiology and economic impact of foot ulcers and amputations in people with diabetes. In: Bowker JH, Pfeifer M, editors. Levin and O’Niel’s the diabetic foot. 7th ed. Philadelphia: Mosby-Elsevier; 2008. p. 3–22.

    Chapter  Google Scholar 

  36. Margolis D, Malay DS, Hoffstad OJ, et al. Incidence of diabetic foot ulcer and lower extremity amputation among Medicare beneficiaries, 2006 to 2008. Rockville: Agency for Healthcare Research and Quality; 2010.

    Google Scholar 

  37. Larsson J, Agardh CD, Apelqvist J, Stenstrom A. Long-term prognosis after healed amputation in patients with diabetes. Clin Orthop Relat Res. 1998 May;(350):149-58. From PubMed.

    Google Scholar 

  38. Pecoraro RE, Ahroni JH, Boyko EJ, Stensel VL. Chronology and determinants of tissue repair in diabetic lower-extremity ulcers. Diabetes. 1991;40:1305–13.

    Article  PubMed  CAS  Google Scholar 

  39. Larsson J, Apelqvist J, Agardh CD, Stenstrom A. Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach? Diabet Med. 1995;12:770–6.

    Article  PubMed  CAS  Google Scholar 

  40. Imperatore G, Cadwell BL, Geiss L, et al. Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: national health and nutrition examination surveys, 1971–2000. Am J Epidemiol. 2004;160:531–9.

    Article  PubMed  Google Scholar 

  41. Engelgau MM, Geiss LS, Saaddine JB, et al. The evolving diabetes burden in the United States. Ann Intern Med. 2004;140:945–50.

    PubMed  Google Scholar 

  42. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26:3333–41.

    Article  Google Scholar 

  43. Centers for Disease Control and Prevention. Diabetes-A serious public health problem, vol. 1–5. Atlanta: U.S. Department of Health and Human Services; 1998.

    Google Scholar 

  44. Eggers PW, Gohdes D, Pugh J. Nontraumatic lower extremity amputations in the Medicare end-stage renal disease population. Kidney Int. 1999;56:1524–33.

    Article  PubMed  CAS  Google Scholar 

  45. Gregg EW, Sorlie P, Paulose-Ram R, et al. Prevalence of lower-extremity disease in the US adult population >=40 years of age with and without diabetes: 1999–2000 national health and nutrition examination survey. Diabetes Care. 2004;27:1591–7.

    Article  PubMed  Google Scholar 

  46. U.S. Department of Health and Human Services. Healthy persons 2010: understanding and improving health, vol. 2. Washington: U.S. Government Printing Office; 2000.

    Google Scholar 

  47. Group TG. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. The global lower extremity amputation study group. Br J Surg. 2000;87:328–37.

    Article  Google Scholar 

  48. Tentolouris N, Al Sabbagh S, Walker MG, Boulton AJ, Jude EB. Mortality in diabetic and nondiabetic patients after amputations performed from 1990 to 1995: a 5-year follow-up study. Diabetes Care. 2004;27:1598–604.

    Article  PubMed  Google Scholar 

  49. Stockl K, Vanderplas A, Tafese E, Chang E. Costs of lower-extremity ulcers among patients with diabetes. Diabetes Care. 2004;27:2129–34.

    Article  PubMed  Google Scholar 

  50. Harrington C, Zagari MJ, Corea J, Klitenic J. A cost analysis of diabetic lower-extremity ulcers. Diabetes Care. 2000;23:1333–8.

    Article  PubMed  CAS  Google Scholar 

  51. McMillan G, Glover M. The clinical and economic potential of hyperbaric oxygen therapy in the treatment of diabetic ulceration and other conditions. Low Extrem Wounds. 2007;6:130–8.

    Article  Google Scholar 

  52. Margolis D, Malay DS, Hoffstad OJ, et al. Economic burden of diabetic foot ulcers and amputations among Medicare beneficiaries, 2006 to 2008. Rockville: Agency for Healthcare Research and Quality; 2010.

    Google Scholar 

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Correspondence to David J. Margolis M.D., Ph.D. .

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© 2012 Springer-Verlag London

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Margolis, D.J. (2012). Epidemiology of Wounds. In: Mani, R., Romanelli, M., Shukla, V. (eds) Measurements in Wound Healing. Springer, London. https://doi.org/10.1007/978-1-4471-2987-5_8

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  • DOI: https://doi.org/10.1007/978-1-4471-2987-5_8

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