Objective: To assess the impact of the COVID-19 pandemic on venous leg ulcer (VLU) management by the UK's health services and associated outcomes.

Design: Retrospective cohort analysis of the electronic records of patients from The Health Improvement Network database.

Setting: Clinical practice in primary and secondary care.

Participants: A cohort of 1946 patients of whom 1263, 1153 and 733 had a VLU in 2019, 2020 and 2021, respectively.

Primary And Secondary Outcome Measures: Clinical outcomes and wound-related healthcare resource use.

Results: VLU healing rate in 2020 and 2021 decreased by 16% and 42%, respectively, compared with 2019 and time to heal increased by >85%. An estimated 3% of patients in 2020 and 2021 had a COVID-19 infection. Also, 1% of patients in both years had VLU-related sepsis, 0.1%-0.2% developed gangrene and 0.3% and 0.6% underwent an amputation on part of the foot or lower limb in 2020 and 2021 (of whom 57% had diabetes), respectively. The number of community-based face-to-face clinician visits decreased by >50% in both years and >35% fewer patients were referred to a hospital specialist. In 2020 and 2021, up to 20% of patients were prescribed dressings without compression compared with 5% in 2019. The total number of wound care products prescribed in 2020 and 2021 was >50% less than that prescribed in 2019, possibly due to the decreased frequency of dressing change from a mean of once every 11 days in 2019 to once every 21 days in 2020 and 2021.

Conclusions: There was a significant trend towards decreasing care during 2020 and 2021, which was outside the boundaries considered to be good care. This led to poorer outcomes including lower VLU healing rates and increased risk of amputation. Hence, the COVID-19 pandemic appears to have had a deleterious impact on the health of patients with a VLU.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944296PMC
http://dx.doi.org/10.1136/bmjopen-2022-068845DOI Listing

Publication Analysis

Top Keywords

2020 2021
28
impact covid-19
8
venous leg
8
leg ulcer
8
clinical outcomes
8
clinical practice
8
covid-19 pandemic
8
0
8
vlu healing
8
compared 2019
8

Similar Publications

Radiofrequency ablation (RFA) is an interventional procedure that has been used to treat chronic back pain for over 50 years; this unique case report demonstrates the effectiveness of pulsed radiofrequency ablation (PRFA) on the dorsal root ganglion (DRG) in the treatment of chronic radicular pain (Russo et al., 2021, J Pain Res, 14, 3897). The RFA provides pain relief by using thermal energy to disrupt peripheral nerves carrying nociceptive signals back to the central nervous system (Abd-Elsayed et al.

View Article and Find Full Text PDF

Background: This study aimed to evaluate the impact of combined levothyroxine (LT4) and triiodothyronine (LT3) therapy on quality of life in patients with primary hypothyroidism.

Methods: In a randomized, double-blind, parallel-group trial, 151 Iranian patients diagnosed with primary hypothyroidism between 2020 and 2021 were enrolled. One group received LT4 alone (n = 80), while the other received LT4 and LT3 (n = 71) for a minimum of six months.

View Article and Find Full Text PDF

Photobiomodulation and aquatic training reduce TNF-α expression and enhance muscle fiber area in Wistar rats with compensatory hypertrophy.

Lasers Med Sci

January 2025

Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), 235/249 Vergueiro Street, Sao Paulo, SP, 01525000, Brazil.

This study aims to assess the effects of aquatic training (AT) and its combination with photobiomodulation (PBM) on cytokine synthesis and plantar muscle morphology during compensatory hypertrophy (H) in Wistar rats. H was induced by bilateral ablation of synergistic muscles, and PBM using a laser (780 nm). AT involved 60 min sessions, 5 times/week, for 7 and 14 days.

View Article and Find Full Text PDF

Purpose: We examined the impact of the COVID-19 consortium recommendations on the surgical management of breast cancer during the first year of the pandemic.

Methods: Patients with newly diagnosed ER + DCIS, ER- DCIS, AJCC Stage cT1-2N0-1 ER + , HER2-, HER2 + , and triple negative breast cancer were identified from the National Cancer Database from 2018 to 2021. An interrupted time series design evaluated differences in surgical delay and use of neoadjuvant chemotherapy/immunotherapy (NAC) and endocrine therapy (NET) before and after the pandemic.

View Article and Find Full Text PDF

Equity is a cornerstone of global climate policy, yet differing perspectives mean that international agreement on how to allocate mitigation efforts remains elusive. A rich literature informs this question, but a gap remains in approaches that appropriately consider non-CO emissions and their warming contributions. In this study, we address this gap and define a global warming budget applicable to all anthropogenic greenhouse gases that is allocated to countries based on principles drawn from international treaties and environmental law.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!