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Year : 2022  |  Volume : 28  |  Issue : 1  |  Page : 71-75

Prognostic factors related to delayed healing in venous leg ulcers treated with four-layer compression bandaging: A prospective observational study on a cohort of patients

1 Department General Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India
2 Department of Biostatistics, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Correspondence Address:
Dr. Riju Ramachandran
AG-1, Sterling Sarovar, Kosseri Lane, Edapally, Kochi, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_5_22

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Background: Four-layer compression bandage is found to be very effective in healing most venous ulcers. Various causes have been suggested in the literature for delay in healing despite compression. However, Indian literature on venous ulcers, compression bandage and prognostic factors for healing of venous leg ulcers (VLUs) are lacking. This study was a prospective observational study on a cohort of patients with VLU treated with four-layer compression bandage, to assess prognostic factors causing delay in the healing process. Subjects and Methods: After obtaining approval from the institutional review board, all patients with VLUs treated using four-layer compression bandage in the department of general surgery from October 2018 to October 2020 were included in the study. Age, gender, body mass index (BMI), waist–hip ratio, duplex/Doppler findings, culture and sensitivity report of swab taken at the time of first visit and ulcer healing time were recorded. To test the significant association of categorical variables between groups, Chi-square test with continuity correction was applied. Results: There were 150 patients included in the study. Ulcer healed completely in 101 patients, and there was delay/non-healing in 49 (32.7%) patients. Ulcer was more common in male patients and those above 45 years of age (mean age: 57.0200 ± 8.86 years). Female gender had a better prognosis. BMI > 25 (P = 0.04); infection with Pseudomonas (P = 0.001), staphylococci (P = 0.001) and Klebsiella and saphenopopliteal junction (SPJ) incompetence (P = 0.001) adversely affected healing of VLUs. Conclusion: Compression bandage significantly improves wound healing in VLUs. Female gender, obesity, SPJ incompetence and secondary infections are independent risk factors for delayed healing in VLUs.

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