Venous Leg Ulcer-patient Compliance to Treatment and Impact on Quality of Life

Correspondence to: Romeo Bistreanu, Tg Jiu, Calea Severinului, nr.173, Gorj.E-mail:[email protected] ABSTRACT: Venous ulceration is the most undesirable consequence of exposure to the elevated venous pressure associated with chronic venous insufficiency (CVI). Approximately 1% of the population are at significant risk for development of venous leg ulcer and the incidence of pathology increases among the elderly population. Ulcers often take years to heal and a major problem among patients is compliance to treatment (surgical or conservative), especially to long-term regimes. Applying compression bandages or stockings is considered essential in venous leg ulcer treatment. These bandages or stockings need to be worn as long as there is evidence of venous disease, vhich often implies a lifelong treatment. Venous leg ulceration has also a major impact on many aspects of daily life: pain is common, patients report sleeping disorders and financial problems, and their mobility and work capacity tend to be restricted. Social isolation due to fear of injury and negative body image are described. Our study has been performed on a group of 105 patients with venous leg ulcer, admitted in 1st Surgical Clinic of County Hospital Timisoara (in a five years period). We also evaluated a group of 142 patients examined in ambulatory unit of the same clinic. Demographic data, the cause of venous insufficiency, ulcer characteristics, comorbidity and patient compliance were studied. Adherence to treatment protocol (phisycian supervised)significantly decreased the time to healing and prolonged the time to reccurrence. About the impact of disease on quality of life, there are questionnaires and methods to analyze this, but the challenge is to move from a focus on wound management to understanding the specific needs of each individual within the context of their life. The influence of ulcer treatment on quality of life depends of appropriate time of surgical intervention and of patient compliance with complex therapy (dressing, stocking, medication and physical exercices).