The influence of surgical treatment for chronic leg ulcers on the quality dynamics of the patient's life.
OBJECTIVE
This study was undertaken to assess the effectiveness of skin grafting and the influence on the quality of the lives of patients who have large chronic venous ulcers.


METHODS
We have performed the perspective analysis of the course of the disease and of treatment results after 6 months. Two groups of patients were involved in the study. Group O contains patients who have been treated by performing skin graft surgery, while group C contains patients who have been treated only by conservative means. All patients studied have been treated during the period of 2001-2005 at the Department of Plastic Surgery and Burns and at the Clinic of Skin and Venereal Diseases (CSVD) of Kaunas Medical University Hospital (KMUH). During the visit patients had to complete a questionnaire (enclosed with patient's history of treatment), according to which we evaluated the influence of large chronic venous leg ulcers on the quality of patients' lives. This questionnaire has been developed in accordance with the questionnaire for the evaluation of quality of life prepared by prof. dr. M. E. Hyland.


RESULTS
At the beginning of the study all patients of O and C groups suffered from pain in the legs. However, at the end of the study, pain decreased only in patients of O group (p < 0.05), while in C group pain practically remained the same. At the beginning of the study, the ulcers deprived many patients from both groups of sleep for most of the night (37-41%). During the repeated questioning it turned out that ulcers only deprived 2.5% of patients in group O of sleep for most of the night, whereas in group C this rose to 19.35%.


CONCLUSIONS
Skin grafting positively influences the quality of patients' lives significantly (p < 0.05). Skin grafting has decreased the limitation of function and improved the dysphoric mood. The coverage of ulcers by autografts of skin thickness, had decreased the leg pain within 6 months, significantly more than by conservative treatment alone (p < 0.05). The amount of patients' personal expenditure on the care and treatment of ulcers, increased within the period of 6 months for 11.2% of patients in whom large CVUL were treated conservatively. The amount of personal expenses decreased to 12.8% of patients in whom skin grafting was applied (p > 0.05).
Jankunas
V
V
Klaipeda University, Lithuania. vjankunas@hotmail.com
Bagdonas
R
R
Samsanavicius
D
D
Rimdeika
R
R
D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000601:surgery*; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D016038:Skin Transplantation; D011795:Surveys and Questionnaires; D013850:Thinking; D013997:Time Factors