[Dynamic wound healing profile of venous ulcus cruris]

The success of venous leg ulcer treatment can be evaluated by various parameters like wound area reduction in square millimeters, percent reduction of ulcer size, reduction of wound radius, and time of wound closure. Which one is the most reliable parameter if different treatment forms (i.e. various ointments) are to be compared? The best parameter for the evaluation of the speed at which chronic ulcers heal was the daily wound radius reduction, calculated from the wound area by planimetry. Under a standardized treatment (polyvidoniodine ointment, pressure bandaging) the daily ulcer radius fell on the average by 0.24 mm indicating a continuous growth of skin tissue from the wound circumference. Conversely, the daily wound area reduction in mm2 or in percent was difficult to interpret due to the parabolic shape of the area reduction curve. Here the following characteristics were noted: Large wounds displayed a relatively quick reduction of the wound area and at the same time a slow percental wound diminution. Small wounds, on the other hand, displayed a relatively slow reduction of the wound area and at the same time a relatively quick percent wound diminution. The period of time during which a wound became completely closed was equally unsuited for the assessment of therapeutic success because large ulcers healed slower than smaller ones. We conclude from these results that reduction of the wound radius should be used as the most reliable parameter for the evaluation of venous leg ulcer healing.