In-patient management of leg ulcers

To review in-patient management of leg ulcers and to compare our experiences with those from other similar centres.

A retrospective study.

University of Benin Teaching Hospital, Nigeria.

Forty five patients hospitalised with leg ulcers.

There were 27 males and 18 females (MF 3:2). The age range was 8-90 years (mean 32.5 years). The commonest sites were around the ankle(55.6%) and the distal third of the leg (40%). Trauma, diabetes mellitus and sickle-cell disease accounted for the commonest aetiological factors(35.6%, 22.2% and 17.8% respectively). Coliforms and Staphylococcus aureus were the commonest organisms isolated on culture. All the patients had routine wound dressing and antibiotics but only 25 patients (56%) responded fully to this line of preliminary management. The other 20 patients had wound debridement in addition. Nineteen patients(42%) needed skin grafting while four patients (9%) had below-knee amputation.

Our experience shows that leg ulcers whose nature portend an increase in morbidity and mortality are best managed as in-patients. The underlying causes should be addressed while local wound care is administered. Skin grafting and amputation should be employed when necessary.