Skene et al developed a prognostic index for healing of a chronic venous leg ulcer. This can help to identify a patient who may benefit from more aggressive management. The authors are from Northwick Park Hospital and Clinical Research Centre in Middlesex, England.
Patient selection: chronic venous leg ulcer
Parameters:
(1) ulcer area in square cm
(2) duration of ulceration in months
(3) age of the patient in years
(4) deep vein involvement on photoplethysmography
Parameter
Finding
Points
ulcer area in square cm
< 1.7 square cm
0
1.7 to 4.89
1
4.9 to 14.19
2
14.2 to 40.89
3
40.9 to 118.3
4
> 118.3 square cm
5
duration of ulceration
< 2 months
0
2 to 31 months
1
> 31 months
2
age of the patient
< 52 years
1
52 to 86 years
2
> 86 years
3
deep vein involvement
no
0
yes
0.5
total score =
= SUM(points for all 4 parameters)
Interpretation:
• mnimum score: 1
• maximum score: 10.5
• The higher the score the lower the chances of healing and the longer the time to healing in days.
Score
Percent Healing
Median Time to Healing
<= 4.0
69%
40 days
4.5 to 5.5
54%
70 days
>= 6.0
8%
118 days
Performance:
• Newer therapeutic methods may improve outcomes over those predicted in 1992.
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