Development of a severity scale for evaluating the need for Graftskin in nonhealing venous ulcers.
OBJECTIVE
To construct an easy-to-use severity scale based on data from a multicenter venous leg ulcer trial to predict which wounds will progress toward closure and which will remain unhealed.


METHODS
Factors that have an impact on wound healing (eg, ulcer duration, depth, area, location, and fibrin) were identified in the literature. A severity scale was constructed based on these factors.


METHODS
Multicenter clinical trial.


METHODS
240 patients with venous leg ulcers of longer than 1 month's duration.


RESULTS
Wound duration and area were identified as having the greatest impact on ulcer healing. Using multivariate regression analyses, a wound score of 8 or less was considered mild to moderate. A severe wound, having a score of 9 or greater, was found to be unlikely to heal with compression therapy alone.


CONCLUSIONS
This severity scale can serve as an adjunctive tool in the prompt identification of ulcers with a poor healing prognosis and enable early intervention with alternate therapies. To optimize the severity scale, future trials should incorporate a method to review the interaction of known factors that impair wound healing.
Kerstein
Morris D
MD
Veterans Administration Hospital, Wilmington, DE, USA.
Brem
Harold
H
Giovino
Katherine B
KB
Sabolinski
Michael
M
D006801:Humans; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016038:Skin Transplantation; D014647:Varicose Ulcer / Q000503:physiopathology* / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology*