A systematic review on risk factors in developing a first-time Venous Leg Ulcer

Area of Science:

• Vascular Medicine
• Dermatology
• Epidemiology

Background:

• Venous Leg Ulcers (VLU) affect 1% of the Western population, with prolonged healing times (3-12 months) and frequent recurrence.
• VLUs significantly impair patients' quality of life.
• Prevention strategies are underdeveloped due to a lack of understanding regarding the risk factors for a first VLU.

Purpose of the Study:

• To systematically review and identify risk factors associated with the development of a first Venous Leg Ulcer in adults.
• To synthesize existing literature on VLU etiology to inform prevention efforts.

Main Methods:

• A comprehensive literature search was conducted in January 2018 across Cochrane Library, PubMed, CINAHL, and NARCIS.
• Two independent reviewers assessed study abstracts and full texts for relevance and methodological quality.
• Included studies focused on risk factors for VLU development, utilizing duplex scanning and comparing participants with and without VLUs; a qualitative analysis was performed, with meta-analysis where feasible.

Main Results:

• Five studies were included, investigating various risk factors for VLU development.
• Methodological heterogeneity precluded quantitative meta-analysis.
• Significant associations were found for higher age, elevated body mass index (BMI), low physical activity, arterial hypertension, deep vein reflux, deep venous thrombosis (DVT), and a family history of VLU.

Conclusions:

• While several factors are associated with VLU development, their precise influence remains unclear due to limited and heterogeneous studies.
• Further research is necessary to confirm these associations and investigate factors like overweight and physical activity in greater detail.
• Enhanced understanding of VLU risk factors is essential for developing effective primary prevention strategies.