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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Robert P Wunderlich, DPM, Diabetex, diabetex, San Antonio, TX 78251, 210-281-9200, robert@wunderlich.com and Lawrence Lavery, DPM, MPH, Orthopaedics and Rehabilitation, Loyola University Medical Center, 2160 S. 1st Ave., Building 54, Maywood, IL 60153.
Venous stasis ulceration of the lower extremity is a common problem among diabetic patients, yet we are unaware of any reports in the literature describing treatment outcomes for these wounds in a diabetic population. Therefore, the purpose of this study was to evaluate clinical outcomes associated with venous stasis ulcers in patients with diabetes. A retrospective chart review was used to identify 95 diabetic subjects with venous stasis ulcers of the leg who underwent treatment with serial compressive dressings. The mean patient age was 73 years with an average duration of diabetes of 13.1 years and an average body-mass index (BMI) of 37.3. Baseline wound size averaged 2.5cm2 , and mean ankle-brachial index (ABI) was 0.96. Compressive dressings were changed weekly until complete wound healing, which averaged 11.5 weeks in duration. During the treatment period, 37.5% of the patients had at least one incidence of documented non-compliance with the treatment plan. Average follow-up duration was 16.4 months, during which time we identified an overall ulcer recurrence rate of 55%. However, the recurrence rate among patients who complied with recommendations to use medical grade compression stockings was only 12.5%. During the treatment period, 3.2% of the patients were hospitalized for cellulitis, but none of the study subjects required an amputation. These results indicate that venous stasis ulcerations can be successfully treated with serial compressive dressings in an outpatient setting, but a high recurrence rate can be expected among patients who refuse to wear compression stockings following wound healing.
Learning Objectives:
Keywords: Diabetes,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.