Milic et al identified factors affecting the healing of a venous leg ulcer after compression therapy. The authors are from the University of Nis and the University of Megatrend in Serbia.
Patient selection: venous leg ulcer with area > 5 square cm for > 3 months, age >= 16 years
Management: multi-layer high compression bandaging for 52 weeks
Outcomes: healing by 26 weeks, healing by 52 weeks, nonhealing
Endpoint: complete epithelialization of the limb (involving initial and any subsequent ulcerations)
Factors associated with healing:
(1) ulcer area < 20 square cm (small)
(2) duration of ulcer < 12 months
(3) decrease in calf circumference > 3 cm during the first 50 days of compression therapy
(4) emergence of new skin islets on > 10% of wound surface during the first 50 days of therapy
Factors associated with slow healing:
(1) body mass index > 33 kg per square meter
(2) walking distance during day < 200 meters
(3) history of surgical wound debridement
(4) deepest point > 2 cm
Factors associated with non-healing:
(1) calf to ankle circumference (CAC) ratio < 1.3
(2) fixed ankle joint with reduced ankle range of motion (ROM)
