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

Yıl 2022, , 91 - 97, 28.04.2022

Şule Subaşı Gökşin , Şafak Şimşek

https://doi.org/10.35440/hutfd.1009266

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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