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Leg ulcers: epidemiology and aetiology
The British Journal of Surgery
|September 1, 1986
Summary
Leg ulcer prevalence in the region was 0.18%, with higher rates in those over 40. Many chronic leg ulcers went untreated, highlighting a need for better community-based care and assessment services.
Area of Science:
- Vascular Medicine
- Epidemiology
- Community Health
Background:
- Leg ulcers represent a significant health burden, with high prevalence and chronicity.
- Many patients with leg ulcers lack access to timely and effective healthcare services.
- Understanding the underlying vascular pathology is crucial for appropriate management.
Purpose of the Study:
- To determine the prevalence of leg ulceration in a defined regional population.
- To investigate the aetiology of leg ulcers, focusing on venous and arterial circulation.
- To assess the current service provision and identify areas for improvement.
Main Methods:
- Prevalence study in a regional Health District.
- Patient data collection including lesion duration and prior healthcare attendance.
- Vascular assessment using ultrasound and photoplethysmography in a random sample of patients.
- Calculation of the mean pressure index for patients with an ischaemic element.
Main Results:
- Overall leg ulcer prevalence was 0.18%, rising to 0.38% in individuals over 40.
- Fifty percent of lesions were chronic (present >1 year), and 62% of patients had no prior hospital attendance.
- Vascular investigations revealed deep vein incompetence (38%), superficial vein incompetence (43%), and an ischaemic element (31% with mean pressure index of 0.62).
Conclusions:
- Leg ulcers are prevalent, often chronic, and frequently undiagnosed or untreated.
- A significant proportion of leg ulcers have underlying venous or arterial insufficiency.
- Integrated community-based services with objective assessment tools can improve care for leg ulcer patients.