Retrospective analysis of leg ulcers casesat the university hospital, Faculty ofMedicine of Ribeirão Preto, Universityof São Paulo (1991-2001)

ABSTRACT

Introduction: Leg ulcers are a syndrome characterized by loss of tegument that affect the lower extremities usually caused by vascular systemdysfunction, representing a high morbidity chronic disease especially among the aged. This study determined the epidemiological characteristics ofleg ulcer patients seen at Clinical Hospital Ribeirão Preto from 1991 to 2001, and their main etiologies and the resolving nature of the treatmentsapplied were investigated.Method: This was a descriptive retrospective study (case series) analyzing 199 medical records of leg ulcer patients, coded by the Medical Recordsfrom 1991 to 2001.Results: 51% of the patients were women and 49% men, with respective median ages of 65 and 66 years, and 81% were white. Etiologically, 49%were classified as venous ulcers, 15% arterial, 9% neuropathic, 2% anemic, and 20% were not classified. Approximately 40% of the patients hadbeen wounded for more than 1 year, 13% died, 40% discharged, and 45% evolved with chronic disease. Among the discharged patients, 64% ofthose with arterial ulcers and 80% of those with neurotrophic ulcers underwent amputation of the segment involved. Regarding venous ulcers, only37% of the patients were discharged, after local dressing in 56% of cases and after skin graft in only one.Comment: Leg ulcer disease was found to be an important chronic disease among the patients seen at the Clinical Hospital Ribeirão Preto from 1991to 2001, with severe consequences regarding the arterial and neurotrophic ulcers, although the etiologic diagnosis was unknown or neglected in20.1% of the cases (AU)

RESUMO

Introdução: Úlcera de perna é uma síndrome caracterizada por perda circunscrita ou irregular do tegumento, que acomete extremidades dos membrosinferiores cuja causa geralmente está na disfunção do sistema vascular. Doença crônica de alta morbidade principalmente na população idosa. Oestudo busca características epidemiológicas dos pacientes com úlceras de perna atendidos no Hospital das Clínicas de Ribeirão Preto, de 1991 a2001, conhecer suas principais etiologias e a resolubilidade dos tratamentos realizados.Metodologia: Estudo descritivo e retrospectivo (série de casos), da análise de 199 prontuários médicos dos pacientes com úlceras de perna, codificadospelo Arquivo Médico, de 1991 a 2001.Leg ulcers are a syndrome characterized by the circumscribedor irregular loss of tegument (dermis or epidermis)that may reach subcutaneous tissue and underlying tissues.The disease involves the lower extremities and thecause usually is related to some dysfunction of the arterialor venous vascular system.[1] The classification may bebased on etiology and therefore leg ulcers are divided intothose due to venous insufficiency (venous ulcers), to arterialinsufficiency (arterial ulcers), to neuropathy (neuropathiculcer/diabetic foot), to red blood cell abnormalities(anemic ulcers), to obliterating thromboangiitis, as well asthose due to causes such as trauma, neoplasia, infections,panniculitis, and pyoderma gangrenosum.[1-4] Among themain predisposing factors are age (elderly individuals), sex(females), obesity, profession (prolonged standing up), vulnerabilityof the legs to traumas and infections, (..) (AU)