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Healing of venous ulcers in an ambulatory care program: the roles of chronic venous insufficiency and patient compliance. J Vasc Surg 1995 Nov;22(5):629-36

Date

11/01/1995

Pubmed ID

7494367

DOI

10.1016/s0741-5214(95)70051-x

Scopus ID

2-s2.0-0028805232   140 Citations

Abstract

PURPOSE: A nurse-managed/physician-supervised treatment program for venous ulceration was evaluated to determine the influence of venous hemodynamics, comorbidities, patient behavior, and ulcer characteristics on time to healing and time to recurrence.

METHODS: The clinical course and long-term follow-up of 71 patients with 99 venous ulcers diagnosed between November 1981 and August 1994 were analyzed by a retrospective review of clinic records. Demographic data, severity of venous insufficiency, ulcer characteristics, and patient compliance were studied. Outcome variables were time to complete ulcer healing and time to first recurrence.

RESULTS: Ninety-one percent of the ulcers healed completely at a median 3.4 months. There were 52 (57%) recurrences at a median 10.4 months. Ulcers on limbs with a venous refill time of 10 seconds or less demonstrated a significantly longer time to complete healing (p < or = 0.03); however, no effect on time to recurrence was observed. Patients who were in strict compliance with the treatment regimen (n = 32) had significantly faster healing (p < or = 0.02) and fewer recurrences (p < or = 0.004) compared with patients who were less compliant (n = 67).

CONCLUSIONS: Most venous ulcers can be expected to heal when patients are enrolled in a nurse-managed/physician-supervised ambulatory ulcer clinic. Photoplethysmography-derived venous refill time of 10 seconds or less predicted delayed healing. Strict compliance with the treatment protocol significantly decreased the time to healing and prolonged the time to recurrence.

Author List

Erickson CA, Lanza DJ, Karp DL, Edwards JW, Seabrook GR, Cambria RA, Freischlag JA, Towne JB

Authors

Debra J. Lanza RN Nurse Practitioner Surgical in the Surgery department at Medical College of Wisconsin
Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Ambulatory Care
Chronic Disease
Combined Modality Therapy
Female
Humans
Life Tables
Male
Middle Aged
Patient Compliance
Recurrence
Retrospective Studies
Time Factors
Varicose Ulcer
Venous Insufficiency
Wound Healing
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