title: Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1 000 patients from 10 specialised dermatological wound care centers in Germany.
abstract: Numerous comorbidities and cofactors have been known to influence wound healing processes. In this multicentre study, clinical data of 1 000 patients with chronic leg ulcers from ten specialised dermatological wound care centers were analysed. The patient cohort comprised 567 females and 433 males with an average age of 69·9 years. The wounds persisted on average for 40·8 months and had a mean size of 43·7 cm(2) . Venous leg ulcers represented the most common entity accounting for 51·3% of all chronic wounds, followed by mixed-type ulcers in 12·9% and arterial ulcerations in 11·0% of the patients. Vasculitis was diagnosed in 4·5%, trauma in 3·2%, pyoderma gangrenosum in 2·8%, lymphoedema in 1·7%, neoplasia in 1·0% and delayed post-surgical wound healing in 0·6% of the included patients. In total, 70·5% of patients suffered from arterial hypertension, 45·2% were obese, 27·2% had non-insulin dependent diabetes, and 24·4% dyslipidaemia. Altogether 18·4% suffered from metabolic syndrome. Cofactors and comorbidities of patients with chronic leg ulcers have previously been studied but not in detail. Here, we were able to demonstrate the existence of several potentially relevant cofactors, comorbidities of their associations and geographical distributions, which should be routinely examined in patients with chronic leg ulcers and - if possible - treated.
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital of Essen, Essen, Germany.
authors.forename: Finja
authors.initials: F
authors.lastname: Jockenhöfer
authors.affiliation: Department of Dermatology and Venereology, University Hospital of Magdeburg, Magdeburg, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Gollnick
authors.affiliation: Institute for Healthcare Research of Dermatology and Health Care Professions, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
authors.affiliation: Department of Dermatology, Allergology and Environment Medicine, Clinical Centre Schwabing Munich, Munich, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Isbary
authors.affiliation: Department of Dermatology and Venereology, University Hospital of Erlangen, Erlangen, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Renner
authors.affiliation: Department of Dermatology, Centre for venous disease of the dermatological and vascular surgery, University Hospital of Bochum, Bochum, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
authors.affiliation: Department of Dermatology and Venereology, University Hospital of Frankfurt a. M., Frankfurt, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Valesky
authors.affiliation: Department of Dermatology, Venereology and Allergology, Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Department of Dermatology, Venereology, University Hospital of Kiel, Keil, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Weichenthal
authors.affiliation: Department of Dermatology, Venereology, University Hospital of Regensburg, Regensburg, Germany.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Karrer
authors.affiliation: General Medical Department, Timaru Public Hospital, SCDHB, Timaru, New Zealand.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kuepper
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital of Essen, Essen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Roesch
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital of Essen, Essen, Germany. joachim.dissemond@uk-essen.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Dissemond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007871:Leg Ulcer / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Chronic wound; Cofactors; Comorbidities; Leg ulcer; Metabolic syndrome