title: Prevalence of leg ulceration in a London population.
abstract: BACKGROUND
  Current prevalence estimates of chronic leg ulceration are frequently based on studies from the 1980s. During the last decade, major changes have occurred in the application of evidence-based practice to this condition.
  
  
  OBJECTIVE
  To determine the prevalence and cause of leg ulceration in a defined geographical population after 8 years of providing standardized evidence based protocols of care.
  
  
  METHODS
  Prospective survey.
  
  
  METHODS
  Patients with leg ulceration of >4 weeks duration) within an integrated acute and community leg ulcer service were ascertained, interviewed and clinically assessed, using a standardized questionnaire on medical history, ulcer details and non-invasive vascular investigation to describe causes. Ulcers were classified by aetiology.
  
  
  RESULTS
  We identified 113 patients in a population of 252 000, giving a crude prevalence of 0.45/1000 (95%CI 0.37-0.54/1000): 0.34/1000 in men, 0.54/1000 in women. Rates were highly dependent on age, increasing to 8.29 (men) and 8.06/1000 (women) in those aged >85 years. Of the responders, 62/113 (55%) had their ulcer for >1 year. Uncomplicated venous ulceration was observed in only 59/138 (43%) ulcerated limbs; a further 21 had ulceration primarily due to arterial disease. Complex causes were present in 48 (35%) limbs, mostly venous disease in combination with diabetes (35%), lymphoedema (42%) and rheumatoid arthritis (26%).
  
  
  CONCLUSIONS
  Our prevalence of chronic leg ulceration is approximately one-third of that predicted by previous studies using similar methodologies in the 1980s. Patients with ulceration have more complex aetiologies than previously recognized, which may be a consequence of both increasing ulcer chronicity and age.
authors.affiliation: Centre for Research and Implementation of Clinical Practice, Thames Valley University, London, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Moffatt
authors.forename: P J
authors.initials: PJ
authors.lastname: Franks
authors.forename: D C
authors.initials: DC
authors.lastname: Doherty
authors.forename: R
authors.initials: R
authors.lastname: Martin
authors.forename: R
authors.initials: R
authors.lastname: Blewett
authors.forename: F
authors.initials: F
authors.lastname: Ross
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D017678:Sex Distribution