Full-thickness leg ulcers: patient demographics and predictors of healing. Multi-Center Leg Ulcer Study Group

Despite increased knowledge about the immediate and underlying causes of chronic leg ulcers, their management remains a challenge. Some ulcers rapidly respond to treatment whereas others do not, and the decision to reassess the patient and treatment modality is usually based on the clinician's own experience.

Following diagnosis of the underlying cause of leg ulcers, 181 patients were screened. The use of a hydrocolloid dressing (DuoDERM) was evaluated in the treatment of 61 patients with 72 full-thickness ulcers. Patient characteristics associated with deep wounds as well as patient and wound characteristics predictive of the extent of healing and time required for healing were identified.

Patients with full-thickness ulcers were more likely to be overweight (P < .001) and not fully mobile (P = .016). During a mean treatment time of 56 days, 54% of the full-thickness ulcers healed. Ulcers were less likely to heal if the patients were men (P = .02) or had diabetes mellitus (P < .003). A > 30% reduction in ulcer area after 2 weeks of treatment was a predictor of both treatment outcome (P = .016) and time required for healing (P = .004). Odor at baseline and advanced age also were associated with increased time required for healing (P = .005 and .017, respectively).

Noninvasive clinical assessments can aid the clinician in predicting treatment outcome and may facilitate the decision to change therapy and evaluate treatment compliance.