title: Factors that influence healing of chronic venous leg ulcers: a retrospective cohort.
abstract: BACKGROUND
  Venous ulcers have a significant impact on patient quality of life, and constitute a worldwide public health problem. Treatment is complex, with high failure rates.
  
  
  OBJECTIVE
  To identify clinical and therapeutic factors that influence healing of venous ulcers.
  
  
  METHODS
  Retrospective cohort study of patients with venous ulcers. Ulcer area was measured at the first visit (T0) and after 6 months (T6) and 1 year (T12). A reduction in ulcer area of 50% or more at T6 and T12 was the outcome of interest, weighted by clinical, demographic and treatment aspects.
  
  
  RESULTS
  Ninety-four patients were included (137 ulcers). A reduction in ulcer area of 50% or more was seen in 40.1% of patients (95%CI 31.9 to 48.4%) at T6 and 49.6% (95%CI 41.2 to 58.1%) at T12. Complete healing occurred in 16.8% (95%CI 10.5 to 23.1%) at T6 and 27% (95%CI 19.5 to 39.5%) at T12. The lowest ulcer area reductions at T6 were associated with longstanding ulcer (RR=0.95; 95%CI 0.91 to 0.98), poor adherence to compression therapy (RR=4.04; 95%CI 1.31 to 12.41), and infection episodes (RR=0.42; 95%CI 0.23 to 0.76). At T12, lower reductions were associated with longstanding ulcer (RR=0.95; 95%CI 0.92 to 0.98), longer topical antibiotic use (RR=0.93; 95%CI 0.87 to 0.99), and systemic antibiotic use (RR=0.63; 95%CI 0.40 to 0.99).
  
  
  CONCLUSIONS
  Longstanding ulcer, infection, poor adherence to compression therapy, and longer topical and systemic antibiotic use were independently correlated with worse healing rates.
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Marilia Formentini
authors.initials: MF
authors.lastname: Scotton
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Hélio Amante
authors.initials: HA
authors.lastname: Miot
authors.affiliation: Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
authors.forename: Luciana Patricia Fernandes
authors.initials: LP
authors.lastname: Abbade
mesh_terms: D000368:Aged; D002908:Chronic Disease; D058128:Compression Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology*