Contemporary management of leg ulcer

• Published in: Acta medica Croatica Vol. 66; no. 5; pp. 387 - 395
• Main Author: Huljev, Dubravko
• Format: Journal Article
• Language: Croatian; English
• Published: Croatia 01-12-2012
• Subjects: Chronic Disease; Female; Humans; Middle Aged; Skin Transplantation; Varicose Ulcer - surgery; Varicose Ulcer - therapy; Venous Insufficiency - complications
• ISSN: 1330-0164

Chronic wounds are becoming an increasing health, economic and social problem worldwide, including Croatia. Most common chronic wounds are the results of venous insufficiency of lower legs, and their incidence is about 75% of all chronic wounds. Costs of treating patients with leg ulcer are not trivial. According to available data from different countries, they range from 1% to 3% of total fund allocated for health care. Expensive, time-consuming, difficult, and often uncertain treatment is still great health, social and economic problem. The paper describes current approach to the treatment of venous leg ulcers, with emphasis on the cost-benefit of this approach. Before hospitalization, the patient was treated without compression therapy, just with local application of various types of coatings for 4 years. There are no precise data on the types of dressings that were used, and no data on the microbiological status of the wound during this period. After admission to the hospital, the first step was approach to preparation and conditioning the bed of leg ulcer. After achieving satisfactory local status, the ulcer was covered by free skin graft. Upon discharge from the hospital, minor residual skin defects were treated with alginate dressings and fully healed within 3 weeks. Total cost of 3-month treatment (one-month preoperative period, hospitalization and time elapsed from discharge from the hospital to complete recovery) was 17,085.95 HRK. An approximate cost estimate of 4-year unsuccessful treatment is more than 100,000.00 HRK. Contemporary and active approach that is consistent with current state-of-the-art can achieve significant cost saving in the treatment of patients with chronic leg ulcer.