Pain and quality of life in patients with vascular leg ulcers: an Italian multicentre study

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Abstract
To assess pain and quality of life in patients with chronic vascular leg ulcers. A multicentre cross-sectional study was conducted. A questionnaire to assess quality of life and report the experience of pain was developed. It incorporated the SF-12 questionnaire and a visual analogue scale (VAS) for the assessment of pain during the day, night and at dressing change. A total of 381 patients (233 females, 148 males) were observed from September to November 2006. The patients had venous (52%), ischaemic (11%), mixed aetiology (10%), hypertensive (2%), microangiopatic (2%), diabetic (9%) and other (14%) types of ulcers. Women experienced more pain and had a worse quality of life than men. Venous ulcers had high mean VAS values during the day (44.4) and night (44.9). However, a higher mean value was recorded at dressing change, when it was similar to the mean for vascular ulcers (57.5 versus 56.3). There was a direct correlation between pain and quality of life, which was worse for ulcers with a longer duration and larger area. Ulcers of less than three months' duration had mean VAS values of 38.7, 36.9, 46.8 compared with 53.8, 53.9, 62.9 for ulcers of over 12 months' duration. Mean SF-12 values for the physical component of the questionnaire also showed that patients whose ulcers had a longer duration had a poorer quality of life (35.9) than patients whose ulcers were more recent (40.9). Vascular leg ulcers are very painful and result in a poor quality of life, with a direct correlation with both ulcer duration and ulcer area. Pain relief is required, particularly at dressing changes, as is the selection of advanced wound dressings.