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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1995 Aug;49(4):385–388. doi: 10.1136/jech.49.4.385

Venous ulcer healing: effect of socioeconomic factors in London.

P J Franks 1, N Bosanquet 1, M Connolly 1, M I Oldroyd 1, C J Moffatt 1, R M Greenhalgh 1, C N McCollum 1
PMCID: PMC1060126  PMID: 7650461

Abstract

OBJECTIVE--To determine which social and clinical factors are associated with healing in patients with venous ulceration. DESIGN--Patients were questioned about social factors at their first visit to a community ulcer clinic. They were treated by high compression bandage system and were interviewed again after 12 weeks. SETTING--Community leg ulcer clinics held in health centres throughout Riverside Health Authority in London. PATIENTS--All patients referred to five community leg ulcer clinics with venous ulceration over a six month period. MAIN OUTCOME MEASURES--These were factors significantly associated with healing within 12 weeks of beginning treatment, measured by odds ratio (OR) given by logistic regression analysis. MAIN RESULTS--Of 168 patients with venous ulceration, 87 (52%) healed after 12 weeks of treatment. Univariate analysis showed that low social class (OR = 3.44, 95% CI 1.17, 10.14), lack of central heating (OR = 2.22, 95% CI 1.18, 4.18), and being single (OR = 2.77, 95% CI 1.15, 6.69) were all significantly associated with delayed healing. After adjustment for the known risk factors of ulcer size, ulcer duration, and general mobility only lack of central heating was still significant (OR = 2.27, 95% CI 1.11, 4.55). The remaining factors failing to achieve statistical significance because of their inter-relationship with the known risk factors. CONCLUSIONS--Clinical features of the ulcer seem to determine the progress of healing in patients with leg ulceration. Although there were associations between socio-economic factors and poor healing, adjustment for clinical risk factors generally led to lower non-significant associations. Only lack of central heating retained its association and may play a part in prolonging healing of venous ulceration.

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Selected References

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  1. Blair S. D., Wright D. D., Backhouse C. M., Riddle E., McCollum C. N. Sustained compression and healing of chronic venous ulcers. BMJ. 1988 Nov 5;297(6657):1159–1161. doi: 10.1136/bmj.297.6657.1159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bosanquet N., Franks P., Moffatt C., Connolly M., Oldroyd M., Brown P., Greenhalgh R., McCollum C. Community leg ulcer clinics: cost-effectiveness. Health Trends. 1993;25(4):146–148. [PubMed] [Google Scholar]
  3. Callam M. J., Harper D. R., Dale J. J., Ruckley C. V. Chronic leg ulceration: socio-economic aspects. Scott Med J. 1988 Dec;33(6):358–360. doi: 10.1177/003693308803300603. [DOI] [PubMed] [Google Scholar]
  4. Callam M. J., Ruckley C. V., Harper D. R., Dale J. J. Chronic ulceration of the leg: extent of the problem and provision of care. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1855–1856. doi: 10.1136/bmj.290.6485.1855. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Colgan M. P., Dormandy J. A., Jones P. W., Schraibman I. G., Shanik D. G., Young R. A. Oxpentifylline treatment of venous ulcers of the leg. BMJ. 1990 Apr 14;300(6730):972–975. doi: 10.1136/bmj.300.6730.972. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cornwall J. V., Doré C. J., Lewis J. D. Leg ulcers: epidemiology and aetiology. Br J Surg. 1986 Sep;73(9):693–696. doi: 10.1002/bjs.1800730905. [DOI] [PubMed] [Google Scholar]
  7. Dale J. J., Callam M. J., Ruckley C. V., Harper D. R., Berrey P. N. Chronic ulcers of the leg: a study of prevalence in a Scottish community. Health Bull (Edinb) 1983 Nov;41(6):310–314. [PubMed] [Google Scholar]
  8. Franks P. J., Wright D. D., Fletcher A. E., Moffatt C. J., Stirling J., Bulpitt C. J., McCollum C. N. A questionnaire to assess risk factors, quality of life, and use of health resources in patients with venous disease. Eur J Surg. 1992 Mar;158(3):149–155. [PubMed] [Google Scholar]
  9. Kikta M. J., Schuler J. J., Meyer J. P., Durham J. R., Eldrup-Jorgensen J., Schwarcz T. H., Flanigan D. P. A prospective, randomized trial of Unna's boots versus hydroactive dressing in the treatment of venous stasis ulcers. J Vasc Surg. 1988 Mar;7(3):478–483. [PubMed] [Google Scholar]
  10. Moffatt C. J., Franks P. J., Oldroyd M., Bosanquet N., Brown P., Greenhalgh R. M., McCollum C. N. Community clinics for leg ulcers and impact on healing. BMJ. 1992 Dec 5;305(6866):1389–1392. doi: 10.1136/bmj.305.6866.1389. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Skene A. I., Smith J. M., Doré C. J., Charlett A., Lewis J. D. Venous leg ulcers: a prognostic index to predict time to healing. BMJ. 1992 Nov 7;305(6862):1119–1121. doi: 10.1136/bmj.305.6862.1119. [DOI] [PMC free article] [PubMed] [Google Scholar]

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