title: Development of a severity scale for evaluating the need for Graftskin in nonhealing venous ulcers.
abstract: 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.
authors: Veterans Administration Hospital, Wilmington, DE, USA.
authors: Morris D
authors: MD
authors: Kerstein
authors: Harold
authors: H
authors: Brem
authors: Katherine B
authors: KB
authors: Giovino
authors: Michael
authors: M
authors: Sabolinski
mesh_terms: 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*