For the first article in the “Foundation” series I chose to start with the most common problem you will encounter as a wound care provider, the venous leg ulcer. Statistically this is the most common ulcer pathology that will present to your clinic. On the initial encounter with the patient with a venous leg ulcer one of the most important things we need to determine is if the ulcer will heal as expected, using conventional wound care methods.
In the article presented today “Risk Factors Associated With the Failure of a Venous Leg Ulcer to Heal” by Dr. Margolis published in the Archives of Dermatology, there is a discussion of risk factors associated with healing failure in venous leg ulcers.
Factors associated with failure of a wound to heal within 24 weeks
Larger wound area
Duration of wound in months
History of venous ligation or stripping
Ankle brachial index less than 0.80
History of hip or knee replacement surgery
Presence of fibrin on more than 50% of wound surface
By recognizing these risk factors at the initial examination we can start the process of mitigating what problems we can and understanding which patient’s will likely need advanced healing modalities, such as autograft or allograft.
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