Wounds in chronic leg oedema

Wounds and chronic oedema are common disorders, but rarely studied together. The objective of this cross‐sectional study was to investigate the point‐prevalence and risk factors of wounds on the leg, in chronic leg oedema. Forty sites in nine countries were included. Of 7077 patients with chronic leg oedema, 12.70% had wounds. Independent risk factors were: peripheral arterial disease (odds ratio (OR) 4.87, 95% confidence intervals (CI) 3.63‐6.52), cellulitis within the past 12 months (OR 2.69, 95% CI 2.25‐3.21), secondary lymphoedema (OR 2.64, 95% CI 1.93‐3.60), being male (OR 2.08, 95% CI 1.78‐2.44), being over 85 years of age (OR 1.80, 95% CI 1.23‐2.62), underweight (OR 1.79, 95% CI 1.14‐2.79), bed bound (OR 1.79, 95% CI 1.01‐3.16), chair bound (OR 1.52, 95% CI 1.18‐1.97), diabetes (OR 1.47, 95% CI 1.23‐1.77), and walking with aid (OR 1·41, 95% CI 1.17‐1.69). 43.22% of those with wounds had clinically defined well‐controlled oedema, associated with a significantly lower risk of wounds (OR 0.50, 95% CI 0.42‐0.58, P < .001). Hard/fibrotic tissue (OR 1.71, 95% CI 1.19‐2.48), and a positive Stemmers sign (OR 1.57, 95% CI 1.05‐2.35) were associated with wounds. The study reinforces the importance of measures to control oedema, as controlled swelling was associated with a 50% lower risk of wounds.