Guideline concordant venous ulcer care predicts healing in a tertiary care Veterans Affairs Medical Center.

Olson JM, Raugi GJ, Nguyen VQ, Yu O, Reiber GE. Guideline concordant venous ulcer care predicts healing in a tertiary care Veterans Affairs Medical Center. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. 2009 Sep 1; 17(5):666-70.

Related HSR&D Project(s)

• RCS 98-353 – Research Career Scientist Award, Senior

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Abstract:

This study describes the impact of 80% adherence to guideline concordant care for compression therapy, moist wound-healing environment, and debridement on venous ulcer outcomes. The retrospective cohort design included patients from a tertiary care Veterans Affairs Medical Center from October 2003 to September 2007. During this 5-year interval, 155 patients with 400 venous ulcers met study inclusion. A majority of ulcers (n = 362) healed, with an average time to healing of 18.1 weeks (range 2-209 weeks, median 10.4 weeks). From the multivariate Poisson regression, the likelihood of ulcer healing increased when compression therapy was provided during at least 80% of visits (relative risk [RR], 1.93; 95% confidence interval [CI], 1.27-2.92) or when a moist wound-healing environment was provided during at least 80% of visits (RR, 1.63; 95% CI, 1.09-2.42). Debridement alone was not significantly associated with ulcer healing (RR, 1.0; 95% CI, 0.61-1.64). Patients who received all three treatments during at least 80% of their visits were more likely to heal than those who received < 80% treatment (RR, 2.52; 95% CI, 1.53-4.16). Guideline concordant venous ulcer care was significantly associated with venous ulcer healing, when provided at 80% or more of patient visits.