Use of ulcer size and initial responses to treatment to predict the healing time of leg ulcers.
OBJECTIVE
To test the following two hypotheses: the initial healing profiles of individual leg ulcers determine the longer-term outcome; healing time can be predicted from an initial ulcer size measurement and a sequence of further measurements recorded after treatment has started.


METHODS
Twenty-three patients with venous leg ulcers were studied (10 male, 13 female). Digital images of the ulcers were taken at weekly intervals; ulcer size was measured electronically and the information stored in an electronic patient record. The healing profile for each ulcer was analysed by linear regression using the correlation coefficient (r) to indicate linearity. For [r] > 0.85 ([r] = modulus of r, [where r is negative], that is good linearity and hence wound healing), the predicted healing time was calculated from the initial size (cm2) and initial healing rate (cm2/week), and was compared with the actual healing time.


RESULTS
The majority of ulcers (17/23) healed with linearity ([r] > 0.85). For these ulcers there was agreement between the predicted healing time and the actual healing time (correlation coefficient 0.95).


CONCLUSIONS
Venous ulcers that respond to treatment appear to heal at a near constant rate. The initial response to treatment can be used to reliably estimate the healing time.
Prince
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Department of Vascular Surgery, Good Hope Hospital NHS Trust, Sutton Coldfield, UK.
Dodds
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D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods* / Q000592:standards; D016018:Least-Squares Analysis; D007871:Leg Ulcer / Q000145:classification / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D017211:Treatment Failure; D014945:Wound Healing