Initial healing rates as predictive factors of venous ulcer healing

The use of a laser-based three-dimensional ulcer measurement

Leskovec, Nada Kecelj MD, MSc
Perme, Maja Pohar PhD
Jezeršek, Matija PhD
Mozina, Janez PhD
Pavlović, Miloš D. MD, PhD
Lunder, Tomaž MD, PhD

¹. Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia, ². Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia, and ³. Institute of Biomedical Informatics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia

Reprint requests: Dr. Tomaž Lunder, MD, PhD, Department of Dermatovenereology, University Medical Center Ljubljana, Zaloška c. 2, SI-1000 Ljubljana, Slovenia. Tel: +386 1 5224280; Fax: +386 1 5224333; Email: [email protected]

Manuscript received: June 14, 2007 Accepted in final form: April 22, 2008

Wound Repair and Regeneration 16(4):p 507-512, July-August 2008.

There is a need for practical methods to predict the healing time of venous leg ulcers. In a prospective cohort study of 81 patients with venous leg ulcers, we used a recently described laser-based three-dimensional measurement of the ulcers at days 0 and 28 to estimate the predictive power of horizontal (HIHR) and vertical initial healing rates (VIHR) for wound healing by week 24. The rates were calculated by Gilman's equation [(A₁−A₂)/((p₁+p₂)/2)_(0–4)] and by its modification [(V₁−V₂)/((A₁+A₂)/2)_(0–4)], respectively. The influence of risk factors on both the initial healing rates was also studied. The HIHR and VIHR are important predictors of healing at 24 weeks. They are not influenced by age, ulcer duration, initial ulcer area, and insufficient sapheno-femoral junction, and/or calf perforating veins. Together with ulcer duration, they are independent predictors of the 24-week healing (the area under ROC curve equals to 0.9). VIHR gives us additional information and significantly improves the prediction of 24-week healing.