1. Kerstein, Morris D. MD, FACS
  2. Brem, Harold MD
  3. Giovino, Katherine B.
  4. Sabolinski, Michael MD


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.