Factors associated with recurrence of venous leg ulcers: A survey and retrospective chart review.

Finlayson K, Edwards H, Courtney M. Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Queensland 4059, Australia.

BACKGROUND: Chronic venous leg ulcers have a significant impact on older individuals' well-being and health care resources. Unfortunately after healing, up to 70% recur.

OBJECTIVE: To examine the relationships between leg ulcer recurrence and physical activity, compression, nutrition, health, psychosocial indicators and self-care activities in order to provide information for preventive strategies.

DESIGN: Survey and retrospective chart review.

SETTINGS: Two metropolitan hospital and three community-based leg ulcer clinics.

SUBJECTS: A sample of 122 community living patients with leg ulcer of venous aetiology which had healed between 12 and 36 months prior to the survey.

METHODS: Data were collected from medical records on demographics, medical history and previous ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer recurrences and history, compression and other self-care activities. All variables clinically or statistically significantly associated with recurrence at the bivariate level were entered into a logistic regression model to determine their independent influences on recurrence.

RESULTS: Median follow-up time was 24 months (range 12-40 months). Sixty-eight percent of participants had recurred. Bivariate analysis found recurrence was positively associated with ulcer duration, cardiac disease, a body mass index
CONCLUSIONS: Results indicate a history of cardiac disease is a risk factor for recurrence; while leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence.

Int J Nurs Stud. 2009 Jan 29. [Epub ahead of print]