skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

The influence of polymorbidity, revascularization, and wound therapy on the healing of arterial ulceration

Original Research

(2277) Views  (740) Full article downloads

Authors: Joerg Tautenhahn, Ralf Lobmann, Brigitte Koenig, Zuhir Halloul, Hans Lippert, Thomas Buerger

Published Date June 2008 Volume 2008:4(3) Pages 683 - 689
DOI: http://dx.doi.org/10.2147/VHRM.S2186

Joerg Tautenhahn1, Ralf Lobmann2, Brigitte Koenig3, Zuhir Halloul1, Hans Lippert1, Thomas Buerger1

1Department of General, Visceral and Vascular Surgery; 2Department of Endocrinology and Metabolism; 3Institute for Medical Microbiology, Medical School, Otto-von-Guericke University, Magdeburg, Germany

Objective: An ulcer categorized as Fontaine’s stage IV represents a chronic wound, risk factor of arteriosclerosis, and co-morbidities which disturb wound healing. Our objective was to analyze wound healing and to assess potential factors affecting the healing process.

Methods: 199 patients were included in this 5-year study. The significance levels were determined by chi-squared and log-rank tests. The calculation of patency rate followed the Kaplan-Meier method.

Results: Mean age and co-morbidities did not differ from those in current epidemiological studies. Of the patients with ulcer latency of more than 13 weeks (up to one year), 40% required vascular surgery. Vascular surgery was not possible for 53 patients and they were treated conservatively. The amputation rate in the conservatively treated group was 37%, whereas in the revascularizated group it was only 16%. Ulcers in patients with revascularization healed in 92% of cases after 24 weeks. In contrast, we found a healing rate of only 40% in the conservatively treated group (p < 0.001). Revascularization appeared more often in diabetic patients (n = 110; p < 0.01) and the wound size and number of infections were elevated (p = 0.03). Among those treated conservatively, wound healing was decelerated (p = 0.01/0.02; χ² test).

Conclusions: The success of revascularization, presence of diabetes mellitus, and wound treatment proved to be prognostic factors for wound healing in arterial ulcers.

Keywords: arterial leg ulcer, wound management, risk factors, revascularization








Readers of this article also read:

Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension
Hepatitis C virus infection and risk of cancer: a population-based cohort study
Dealing with grief related to loss by death and chronic pain: Suggestions for practice. Part 2
Subgroup analysis of large trials can guide further research: a case study of vitamin E and pneumonia
Simultaneous, noninvasive, and transdermal extraction of urea and homocysteine by reverse iontophoresis
Cardiovascular risk during hormonal treatment in patients with prostate cancer
Adherence and persistence with branded antidepressants and generic SSRIs among managed care patients with major depressive disorder
Meeting the needs of medical research with statistical methods
Assessing the variability of the attributable causes of death
Multiple causes of death models for human immunodeficiency virus/acquired immune deficiency syndrome and related mortality in South Africa in 2006 and 2007
  • Join ISVH

    Be part of the World's leading experts in vascular health by joining the International Society of Vascular Health (ISVH)

  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University