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Advances in Skin & Wound Care:
Features: Original Investigations

Development of a Severity Scale for Evaluating the Need for Graftskin in Nonhealing Venous Ulcers

Kerstein, Morris D. MD, FACS; Brem, Harold MD; Giovino, Katherine B.; Sabolinski, Michael MD

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OBJECTIVE: To construct an easy-to-use severity scale based on data from a multicenter venous leg ulcer trial to predict which wounds will progress toward closure and which will remain unhealed.

DESIGN: Factors that have an impact on wound healing (eg, ulcer duration, depth, area, location, and fibrin) were identified in the literature. A severity scale was constructed based on these factors.

SETTING: Multicenter clinical trial.

PATIENTS: 240 patients with venous leg ulcers of longer than 1 month’s duration.

MAIN RESULTS: Wound duration and area were identified as having the greatest impact on ulcer healing. Using multivariate regression analyses, a wound score of 8 or less was considered mild to moderate. A severe wound, having a score of 9 or greater, was found to be unlikely to heal with compression therapy alone.

CONCLUSION: This severity scale can serve as an adjunctive tool in the prompt identification of ulcers with a poor healing prognosis and enable early intervention with alternate therapies. To optimize the severity scale, future trials should incorporate a method to review the interaction of known factors that impair wound healing.

© 2002 Wolters Kluwer Health | Lippincott Williams & Wilkins. All world rights reserved.


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