title: Prognostic factors associated with healing of venous leg ulcers: a multicentre, prospective, cohort study.
abstract: BACKGROUND
  Some prognostic markers of venous leg ulcer (VLU) healing have been evaluated, mostly in retrospective studies.
  
  
  OBJECTIVE
  To identify which clinical characteristics, among those known as possible prognostic factors of VLU healing, and which VLU-associated sociodemographic and psychological factors, are associated with complete healing at week 24 (W24).
  
  
  METHODS
  A prospective, multicentre, cohort study was conducted in 22 French dermatology departments between September 2003 and December 2007. The end point was comparison between healed and nonhealed VLUs at W24, for patient clinical and biological characteristics; psychological, cognitive and social assessments; affected leg inclusion characteristics; venous insufficiency treatment and percentage of initial wound area reduction during follow-up.
  
  
  RESULTS
  In total, 104 VLUs in 104 patients were included; 94 were analysed. The mean VLU area and duration were 36.8 ± 55.5 cm2 and 24.8 ± 45.7 months, respectively. At W24, 41/94 VLUs were healed. Univariate analysis significantly associated complete healing with superficial venous surgery (P = 0.001), adherence to compression therapy at W4 (P = 0.03) and W24 (P = 0.01), ankle-joint ankylosis (P = 0.01) and mean percentage of VLU area reduction at W4 (P = 0.04). Multivariate analysis retained superficial venous surgery during follow-up [odds ratio (OR) 8.4, 95% confidence interval (CI) 1.9-48.2] and percentage reduction of the VLU area at W4 (OR 1.6, 95% CI 1.0-2.14) as being independently associated with healing.
  
  
  CONCLUSIONS
  These results indicate that complete healing of long-standing, large VLUs is independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.
authors.affiliation: Department of Dermatology, Hôpital Sud, University of Amiens, 80054, Amiens, France.
authors.forename: G
authors.initials: G
authors.lastname: Chaby
authors.forename: P
authors.initials: P
authors.lastname: Senet
authors.forename: O
authors.initials: O
authors.lastname: Ganry
authors.forename: A
authors.initials: A
authors.lastname: Caudron
authors.forename: D
authors.initials: D
authors.lastname: Thuillier
authors.forename: C
authors.initials: C
authors.lastname: Debure
authors.forename: S
authors.initials: S
authors.lastname: Meaume
authors.forename: F
authors.initials: F
authors.lastname: Truchetet
authors.forename: P
authors.initials: P
authors.lastname: Combemale
authors.forename: F
authors.initials: F
authors.lastname: Skowron
authors.forename: P
authors.initials: P
authors.lastname: Joly
authors.forename: C
authors.initials: C
authors.lastname: Lok
mesh_terms: D000368:Aged; D003866:Depressive Disorder / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012649:Self Concept; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D014945:Wound Healing / Q000502:physiology*