Studies on leg and foot ulcers.
The medical records of patients with leg and foot ulcers caused by vascular disorders were investigated in Göteborg in 1980. The prevalence was estimated to be about 0.3%. The median age of all patients was 73 years. Sixty per cent of the patients were women. There were small differences in the number of leg and foot ulcers cases in each age-group per 1000 inhabitants between men and women. The prevalence of ulcers increased rapidly with age, especially after the age of 70. Seventeen per cent of the patients had ulcers on the medial side of the leg around the ankle only and about 30% on the feet only. Leg and foot ulcer patients were treated by several different specialties and mostly (76%) as outpatients only. From the total of 1377 ulcer patients, 350 patients, who had consulted the Department of Dermatology in 1980 were asked to come for an interview in 1984. Ulcers had been present at some time in each of the years 1981, 1982 and 1983 in 44% of the interviewed patients. During 1980, 24% of the ulcers healed and did not recur before the end of the study. During the follow-up period (3.5 years) 27% of the patients had died. The mortality rate for the leg and foot ulcer patients during the follow-up period was twice as high for both men and women as for the same age groups in the population of Göteborg, during the same years. The risk of dying from ischaemic heart disease was also approximately doubled, but the risk of dying from malignancies was the same. Compression bandages are the most important in the treatment of venous leg ulcers. The pressure under a bandage is proportional to the number of bandage layers with constant stretch. A simple method of regulating the highest comfortable sub-bandage pressure was developed. The number of bandage layers was increased gradually with the same stretch in 30 patients. The reproducibility of the method was tested for different nurses. Compression bandages are often applied for long-term treatment as double bandages. Six women treated for long periods with double bandages for venous leg ulcers developed painful, bright red, glistening skin lesions with pustules, denuded skin and scales as in intertriginous candidiasis. Cultures showed growth of Candida albicans and antimycotic treatment resulted in relief of pain and healing of skin lesions.(ABSTRACT TRUNCATED AT 400 WORDS)
Hansson
C
C
Department of Dermatology, University of Göteborg, Sweden.
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D001458:Bandages; D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007871:Leg Ulcer / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors; D012883:Skin Ulcer / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D013548:Sweden