title: W.A.R. scores in patients with chronic leg ulcers: results of a multicentre study.
abstract: OBJECTIVE
  To assess the individual patient's risk of wound infection using the wounds-at-risk (W.A.R.) score developed by a group of interdisciplinary experts.
  
  
  METHODS
  The W.A.R. score is a clinical test in which, based on anamnestic and clinical criteria, wound patients are assigned point values, where a score of less than or equal to 3 indicates a need for antimicrobial treatment.
  
  
  RESULTS
  The data of 970 patients (553 women, 417 men) with chronic leg ulcers were evaluated at 10 dermatological wound clinics in different regions within Germany. The age of the patients was between 10 and 100 years (mean of 69.8 years); the duration of the wounds was between 2 months and 68 years (mean of 41.1 months). Wound sizes were between 1 and 736 cm² (mean of 42.8 cm²). Overall, W.A.R. scores of <3 points were found in 73.1% of patients and scores of greater than or equal to 3 were found in 26.9% [corrected] of patients. There were significant differences in W.A.R. scores by regions with respect to the bacterial species detected and the aetiologies of the wounds.
  
  
  CONCLUSIONS
  Our multicentre study is the first evaluation of clinical data using the newly established W.A.R. scores. We were able to show that the W.A.R. scores are able to identify a segment of the patient population for whom it can be assumed that they are prone to an increased risk of wound infections unless appropriate antimicrobial action is taken. The W.A.R. score is a simple clinical score that identifies patients with an increased risk of wound infection.
authors.affiliation: MD, Department of Dermatology, Venereology and Allergology, University Hospital Essen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Jockenhöfer
authors.affiliation: Professor, MD, Department of Dermatology and Venereology, University Hospital Magdeburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Gollnick
authors.affiliation: MD, CV-Derm, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
authors.affiliation: MD, Department of Dermatology, Allergology and Environmental Medicine, University Hospital Munich-Schwabing, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Isbary
authors.affiliation: Associate Professor, MD, Department of Dermatology and Venereology, University Hospital Erlangen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Renner
authors.affiliation: Professor, MD, Vein Centre, St. Maria-Hilf Hospital, Ruhr University Bochum, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stücker
authors.affiliation: MD, Department of Dermatology and Venereology, University Hospital Frankfurt am Main, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Valesky
authors.affiliation: Professor, MD, Department of Dermatology, Hospital Dresden Friedrichstadt, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Professor, MD, Department of Dermatology and Venereology, University Hospital Kiel, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Weichenthal
authors.affiliation: Professor, MD, Department of Dermatology and Venereology, University Hospital Regensburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Karrer
authors.affiliation: MD, Department of Dermatology, Venereology and Allergology, University Hospital Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stoffels-Weindorf
authors.affiliation: Professor, MD, Department of Dermatology, Venereology and Allergology, University Hospital Essen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Dissemond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001645:Biguanides / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007871:Leg Ulcer / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D018570:Risk Assessment; D014946:Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000890:Anti-Infective Agents; D001645:Biguanides; C031233:polihexanide