Venous leg ulcers account for 40 to 70% of all chronic wounds, afflict 1 million Americans per year, and standard treatment for these patients is estimated to cost more than l billion dollars per year. The current standard therapy for these wounds is a limb compression bandage, which at best has a success rate of 70 to 80%. Very little information exists that can be used to predict who will have a successful outcome. The hypothesis of this proposal is that there are identifiable risk factors that can be used to predict which individuals will have a successful outcome. A statistically powerful prediction model will be created using logistic regression analysis based on a dataset derived from the candidate's clinical practice and the control inns of industry sponsored trials. This model will be validated using a split sample technique, and by a prospective study in Penn's Cutaneous Ulcer Center. It will provide information that will guide the design of studies to evaluate new therapies, establish relationships between risk factor and wound healing which will lead to properly controlled hypothesis driven research, and may demonstrate two clinically distinct subsets of patients with venous led ulcers.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08AG000715-05
Application #
6029719
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Project Start
1995-09-15
Project End
2000-06-30
Budget Start
1999-07-01
Budget End
2000-06-30
Support Year
5
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Dermatology
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Margolis, David J; Bilker, Warren; Santanna, Jill et al. (2002) Venous leg ulcer: incidence and prevalence in the elderly. J Am Acad Dermatol 46:381-6
Margolis, David J; Bilker, Warren; Knauss, Jill et al. (2002) The incidence and prevalence of pressure ulcers among elderly patients in general medical practice. Ann Epidemiol 12:321-5
Margolis, D J; Berlin, J A; Strom, B L (2000) Which venous leg ulcers will heal with limb compression bandages? Am J Med 109:15-9
Margolis, D J; Kantor, J; Santanna, J et al. (2000) Risk factors for delayed healing of neuropathic diabetic foot ulcers: a pooled analysis. Arch Dermatol 136:1531-5
Kantor, J; Margolis, D J (2000) A multicentre study of percentage change in venous leg ulcer area as a prognostic index of healing at 24 weeks. Br J Dermatol 142:960-4
Margolis, D J; Berlin, J A; Strom, B L (1999) A comparison of sensitivity analyses of the effect of wound duration on wound healing. J Clin Epidemiol 52:123-8
Margolis, D J; Berlin, J A; Strom, B L (1999) Risk factors associated with the failure of a venous leg ulcer to heal. Arch Dermatol 135:920-6
Margolis, D J; Halpern, A C; Rebbeck, T et al. (1998) Validation of a melanoma prognostic model. Arch Dermatol 134:1597-601
Margolis, D J; Attie, M; Leyden, J J (1996) Effects of isotretinoin on bone mineralization during routine therapy with isotretinoin for acne vulgaris. Arch Dermatol 132:769-74