Healing times and the need for hospitalization for leg ulcers of different etiologies

Background: Leg ulcers are a symptom of a heterogeneous group of diseases. Their treatment causes substantial costs due to the long healing times and extensive wound care measures. There is a paucity of information about healing times and the necessity of hospital treatment for leg ulcers of different etiologies.

Methods: In this retrospective study, healing times and the frequency of in-hospital treatment of 355 patients with leg ulcers attending a wound care clinic of a university hospital were examined.

Results: The proportion of healed ulcers was 32.0% after 3 months and 54.3% after 6 months with an average treatment duration of 6.1 months for all ulcers. This proportion of healed ulcers was higher for venous ulcers with 45.5% after 3 months and 63.0% after 6 months, whereas only 30.0% of mixed arterial-venous ulcers and 35.0% of hypertensive ischemic leg ulcers (HYTILU) were healed after 6 months. Of the latter group, 71% of patients were hospitalized at least once during the observation period as compared to 47% of patients with a venous ulcer. The duration of the hospital stay was longer for mixed ulcers and HYTILU with an average of 30 days vs. 23 days for venous ulcers.

Conclusions: These data indicate that the healing times of ulcers of different etiologies differ substantially and that especially ulcers with arteriosclerosis as a causative factor have longer healing times. The fact that they require in-hospital treatment more frequently and for longer periods has significant socio-economic consequences.