부산대학교 도서관

Background: Non-healing plantar ulcers are one of the significant causes of disability in leprosy patients. Plantar ulcers often take months or years to heal, affecting the patient's quality of life. Presence of comorbid conditions in these patients can delay wound healing. The study aimed to evaluate the role of associated comorbid conditions as risk factors in ulcer healing. Methodology/Principal findings: A total of 66 leprosy patients with plantar ulcers registered at LEPRA Society-Blue Peter Public Health and Research Center (BPHRC), Hyderabad, India from June 2018 to June 2019 were studied. Comprehensive clinical assessment was done, including screening for comorbid conditions and treated as per the recommended guidelines. About two-thirds of the participants were aged 50 and above, of which more than half were illiterates, and 93.5% were living below the poverty line. Majority of ulcers were seen on the forefoot; with the head of meta-tarsal bone 27 (41.6%) as the commonest site, followed by calcaneum 23 (38.3%) and great toe 10 (16.6%). Mean ulcer depth was 0.61 (0.57) cm, the area was 5.24 (6.73) cm2 and ulcer volume was 4.72 (14.33) cm3. Ulcer dimensions were significantly associated with low body mass index, hypertension and smoking. Conclusions/Significance: Identifying the risk factors delaying wound healing and detailed assessment of ulcers are of profound importance to predict the outcome of plantar ulcers in leprosy patients. The study findings indicate the need for better policies by the leprosy control program for the comprehensive management of plantar ulcers. Author summary: Plantar ulceration is a major cause of disability in leprosy patients. Most of the ulcers are chronic, which occur even years after completion of Multidrug therapy (MDT) and do not heal despite proper wound care and dressings. Understanding the factors associated with non-healing of plantar ulcers and identifying appropriate control measures could be one of the major interventions for preventing disability in leprosy patients. We undertook a study on 66 leprosy patients with plantar ulcers in these lines. Most of the ulcers were seen on the forefoot, with meta-tarsal bone involvement, the most vulnerable pressure point, indicating the necessity for its protection to prevent the occurrence of ulcers. Key findings from this study are a significant association of increased ulcer dimensions with low body mass index, hypertension and smoking. Further studies are required to establish the role of these comorbidities in causation and progression of ulcer. [ABSTRACT FROM AUTHOR]