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Venous leg ulcers - the search for a prognostic indicator
Keith Moore1, Elizabeth Huddleston, Michael C Stacey
1WoundSci, PO Box 32, Usk, Monmouthshire NP15 1YU, UK. km@woundscience.com
International Wound Journal
|July 27, 2007
Summary
Chronic wound healing can be assessed using various biomarkers. New molecular combinations are needed for accurate prediction of healing status in venous leg ulcers.
Area of Science:
- Wound healing research
- Biomarker discovery
- Chronic wound management
Background:
- Disordered cell function in chronic wounds creates measurable parameters.
- These parameters theoretically can form a wound assessment system for disease severity and treatment response.
- Venous leg ulcers (VLUs) are a common type of chronic wound.
Purpose of the Study:
- To review existing studies on tissue, wound exudate, and microbiology in VLUs.
- To identify parameters associated with VLU healing status.
- To evaluate the potential of these parameters for a wound assessment system.
Main Methods:
- Literature review of studies on venous leg ulcers.
- Identification of biomarkers related to healing status, including cytokines, proteases, senescence markers, oxidative stress markers, and microbiological status.
- Analysis of existing data on the prognostic value of these biomarkers.
Main Results:
- Numerous parameters (cytokines, proteases, senescence markers, oxidative stress, microbiology) are associated with VLU healing status.
- Some parameters, like protease levels in wound exudate, have been proposed as prognostic indicators.
- No published data validate known wound components for accurately reflecting individual patient wound progression.
Conclusions:
- While many biomarkers are associated with chronic wound healing, a validated system for individual patient monitoring is lacking.
- Further characterization of known biomarkers is less critical than identifying novel molecular combinations.
- Developing an accurate, objective test for predicting chronic wound outcomes requires identifying novel molecules that vary coordinately with healing status.
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