LEV 7. Location of Venous Leg Ulcer as a Predictor of Poor Healing

Abstract

There are several factors that influence venous hypertension, which can result in disagreement in the literature regarding risk factors for delayed wound healing. The objective of this study was to identify whether the locations of venous leg ulcers (VLUs) can be an independent risk factor for determining a poor healing rate compared with other common risk factors. We performed a single-center retrospective review of patients diagnosed and treated with VLUs from 2013 through 2017. Those who had a complete medical record with photographic confirmation were included; patients with arterial and severe lymphatic disease were excluded. Ulcer location was divided into four regions: internal supramalleolar, internal inframalleolar, external supramalleolar, and external inframalleolar. Other risk factors were analyzed. The etiology of venous hypertension was also considered. A good healing rate was defined by a 30% reduction at week 4. The healing times for individual factors were compared with Kaplan-Meier method curves and the log-rank test, with a P value of < .05 necessary for statistical significance. There were 160 ulcers in 102 patients eligible for analysis. Ulcer location was 50% internal supramalleolar, 20% internal inframalleolar, 15% external supramalleolar, and 15% external inframalleolar. Location other than internal supramalleolar was identified with delayed healing (P = .04). Age, body mass index, size, and time with ulcer were not found to be risk factors. The location of VLUs outside of the internal supramalleolar area can be considered an independent risk factor for delayed healing.