Use of ulcer size and initial responses to treatment to predict the healing time of leg ulcers

Abstract

OBJECTIVE: To test the following two hypotheses: the initial healing profiles of individual leg ulcers determine the longer-term outcome; healing time can be predicted from an initial ulcer size measurement and a sequence of further measurements recorded after treatment has started. METHOD: Twenty-three patients with venous leg ulcers were studied (10 male, 13 female). Digital images of the ulcers were taken at weekly intervals; ulcer size was measured electronically and the information stored in an electronic patient record. The healing profile for each ulcer was analysed by linear regression using the correlation coefficient (r) to indicate linearity. For [r] > 0.85 ([r] = modulus of r, [where r is negative], that is good linearity and hence wound healing), the predicted healing time was calculated from the initial size (cm2) and initial healing rate (cm2/week), and was compared with the actual healing time. RESULTS: The majority of ulcers (17/23) healed with linearity ([r] > 0.85). For these ulcers there was agreement between the predicted healing time and the actual healing time (correlation coefficient 0.95). CONCLUSION: Venous ulcers that respond to treatment appear to heal at a near constant rate. The initial response to treatment can be used to reliably estimate the healing time.