Quality of Life Assessment in the Management of Venous Leg Ulcers

Chronic venous insufficiency and venous leg ulcers remain a major challenge in wound care, with profound effects on patient health and quality of life. This prospective observational study compared clinical outcomes and patient-reported quality of life following conservative or surgical treatment of venous leg ulcers at Miguel Servet University Hospital, Spain, between 2017 and 2021. Fifty-two patients completed baseline and follow-up assessments with the 36-Item Short Form Health Survey and the Charing Cross Venous Ulcer Questionnaire. Conservative therapy was associated with a significantly shorter mean estimated time to healing compared with surgical treatment (average 21.5 vs. 34.1 weeks, p = 0.019) and greater ulcer area reduction (97% vs. 78.9%, p = 0.034) than surgical treatment with skin grafting and autologous fat transfer. Although complete closure rates were higher in the conservative group (66.7% vs. 47.4%), the difference was not statistically significant. Quality of life improvements were greater in the conservative group, with significant gains in bodily pain, general health, vitality and emotional well-being. Multivariate analysis identified smaller ulcer size, fewer comorbidities and conservative treatment as independent predictors of quality of life improvement. Surgical intervention yielded modest benefits, limited to vitality. These findings demonstrate that improvements in quality of life are closely tied to ulcer healing rather than treatment modality. The study underscores the efficacy of compression therapy and highlights the importance of patient-reported outcomes as essential endpoints in the evaluation of venous leg ulcer management.