The Impact of COVID-19 Pandemic on Vascular Leg Ulcers

Area of Science:

• Vascular Surgery
• Infectious Disease Epidemiology
• Public Health Policy

Background:

• Nonhealing vascular ulcers of lower limbs require consistent medical management.
• Coronavirus disease 2019 (COVID-19) pandemic necessitated public health interventions, including lockdowns.
• Lockdowns restricted patient access to healthcare facilities, potentially disrupting chronic wound care.

Purpose of the Study:

• To evaluate the impact of two COVID-19 lockdown periods on the management and clinical course of nonhealing vascular ulcers of lower limbs.
• To compare outcomes during lockdown periods with pre-pandemic data.
• To assess the effectiveness of telemedicine in managing vascular wounds during restricted periods.

Main Methods:

• Retrospective analysis of 41 patients with nonhealing vascular ulcers.
• Comparison of wound characteristics (pain, recurrence, severity, infection) and treatment outcomes before and during two distinct COVID-19 lockdown periods.
• Utilized direct outreach and telemedicine for follow-up during the second lockdown.

Main Results:

• The first lockdown was associated with increased pain, wound recurrence, severity, and infection rates, alongside a higher risk of lower-limb amputation.
• During the second, less restrictive lockdown, telemedicine follow-up prevented further deterioration of skin lesions.
• Overall, pandemic-related healthcare disruptions negatively affected vascular wound management, increasing severity and mortality risk.

Conclusions:

• COVID-19 pandemic lockdowns pose significant challenges to the effective management of vascular leg ulcers.
• The severity of negative impacts on vascular wounds appears proportional to the restrictiveness of lockdown measures.
• Maintaining consistent patient follow-up, potentially via telemedicine, is crucial during public health crises to mitigate adverse outcomes in chronic wound care.