Clinical Characteristics, Wound Culture Results and Ulcer-Related Dermatological Findings in Patients with Active Venous Ulcers

Öz

Background: The aim of this study was to determine clinical characteristics, wound culture results and ulcer-related dermatological findings in patients with active venous ulcers.
Materials and Methods: 28 patients with active venous ulcers were included in the study. Patient’s data were analyzed retrospectively.
Results: 89.2% of the patients were male and 75% were over 40 years old. Mean age was 53.89 ± 14.46. Secondary etiologic causes (71.5%) were in the first place. Anatomically, deep venous involvement (78.6%) was the most common. Postthrombotic syndrome was in 64.3% and isolated venous insufficiency in 35.7% of the patients. While 42.8% of the patients had ulcers for the first time, others (57.2%) had recurrent ulcers. The average ulcer duration was 3.08 ± 3.35 years. The average ulcer size was 6.3 x 8,4 cm2. Venous ulcer was on the left in 50%, on the right in 42.8% and on both extremities in 7.2% of the patients. Ulcer was frequently sole (89.2%). Ulcer was mostly located above medial malleolus (71.5%). The most common microorganisms grown in wound culture were pseudomonas aeruginosa (32.1%), proteus mirabilis (28.5%), escherchia coli (28.5%) and staphylococcus aureus (21.3%), respectively. Ulcer-related dermatological find-ings were lipodermatosclerosis (92.8%), hyperpigmentation (92.8%), edema (75%), eczematous stasis dermatitis (32.1%), corona phlebectatica (28.5%), lichenification (25%), phlebolymphedema (17.8%), celluli-tis (17.8%), atrophie blanche (10.8%), autosensitization dermatitis (7.1%) and onychomycosis (21.3%).
Conclusions: Active venous ulcer is clinically the last stage of chronic venous insufficiency. Venous ulcer treatment is difficult and recurrence is frequent. A multidisciplinary approach is required to achieve success in the treatment of venous ulcers.

Keywords: Venous ulcer, Etiology, Clinic, Skin findings, Culture, Microorganism

Aktif Venöz Ülseri Olan Hastalarda Klinik Özellikler, Yara Kültürü Sonuçları ve Ülserle İlişkili Dermatolojik Bulgular

Öz

Amaç: Bu çalışmanın amacı, aktif venöz ülseri olan hastalarda klinik özellikleri, yara kültürü sonuçları ve ülserle ilişkili dermatolojik bulguları belirlemekti. Materyal ve Metod: Çalışmamıza aktif venöz ülseri olan 28 hasta dahil edildi. Veriler hasta dosyalarından geriye dönük olarak analiz edildi. Bulgular: Hastaların %89,2'si erkek,% 75'i 40 yaşın üzerindeydi. Ortalama yaş 53,89 ± 14,46 idi. Hastaların %42,8'inde ilk kez ülser görülürken, diğerlerinde (%57,2) tekrarlayan ülser vardı. Ortalama ülser süresi 3,08 ± 3,35 yıldı. Ortalama ülser boyutu 6,3 x 8,4 cm2 idi. Venöz ülser hastaların %50'sinde solda, %42.8'inde sağda ve %7.2'sinde her iki ekstremitede idi. Ülser sıklıkla tekti (%89.2). Ülser en çok medial malleolün (%71,5) üzerinde yerleşmişti. Etiyolojide ikincil nedenler (%71,5) ilk sırada yer aldı. Anatomik olarak derin venöz tutulum (%78.6) en sıktı. Hastaların %64.3'ünde posttrombotik sendrom ve %35.7'sinde izole venöz yetmezlik vardı. Yara kültüründe en sık üreyen mikroorganizmalar sırasıyla pseudomonas aeruginosa (%32,1), proteus mirabilis (%28,5), escherchia coli (%28,5) ve staphylococcus aureus (%21,3) idi. Ülserle ilişkili dermatolojik bulgular; lipodermatoskleroz (%92,8), hiperpigmentasyon (%92,8), ödem (%75), ekzematöz staz dermatiti (%32,1), korona flebektatika (%28,5), likenifikasyon (%25), flebolenfödem (%17,8), selülit (%17,8), atrofi blanche (%10,8), otosensitizasyon dermatiti (%7.1) ve onikomikoz (%21,3) idi. Sonuç: Aktif venöz ülser klinik olarak kronik venöz yetmezliğin son aşamasıdır. Venöz ülser tedavisi zordur ve nüksü sıktır. Venöz ülser tedavisinde başarıya ulaşmak için multidisipliner bir yaklaşım gereklidir.

Anahtar Kelimeler

• venous
• ulcer
• etiology
• clinic
• dermatological finding
• microbiological culture

Kaynakça

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