Relationship of Baseline Wound Area and Oral Antibiotics with Wound Healing in Chronic Venous Leg Ulcers Over Time

Purpose: Venous leg ulcers affect 1% of the population and have extremely high morbidity and contribute to increased health-care costs as well as decreased functional status and lower quality of life. The relationship of antibiotic use and healing status remains unclear.1,2 This study examined the relationships among oral antibiotic intake and baseline wound size in wound healing in a cohort of older adults with chronic venous leg ulcers (CVLUs).

Methods: These data were collected from the first 66 participants in an ongoing longitudinal descriptive cohort study (R01NR016986). Oral antibiotics intake was assessed through electronic medical records and participant report. Wound size, wound perimeter, area, and volume were measured by the Silhouette (ARANZ Medical), a hand-held device that provides laser guided accuracy of the length, width, and depth of the wound in millimeters. Bayesian censored regression models were used to test for differences in time to healing during the eight-week study period after controlling for selected covariates.

Summary of Results:

Conclusion: The mean age of participants was 70.8 ± 9.1 years, 22 (55%) participants were female, and 35 (87.5%) were white. At the eight-week measure, there were 39 participants with non-healed CVLUs and 27 with healed CVLUs. Our results indicate that oral antibiotics were associated with less time to healing, controlling for age, comorbidity index and baseline wound area. Further, the association differed depending on baseline wound area (the antibiotic * area interaction). While wounds with larger areas take longer to heal, use of antibiotics reduced the impact of the initial wound area, resulting in less time to heal for a given initial wound size. Additional studies with larger cohorts are needed to test these concepts independently, improve understanding of the relationship of oral antibiotics and healing trajectories, particularly in larger wounds, and to develop targeted interventions for personalized treatment of CVLUs.