Prevalence of venous leg ulcer : the importance of the data collection method

Many epidemiological studies have been performed to assess leg ulcer prevalence, but not all have given reliable results due to weaknesses in the methodology. A proper prevalence assessment is not easily done and requires time and effort. Most studies have just focused on prevalence of leg ulcers of all causes and only a few have really validated the leg ulcer diagnosis objectively by use of hand-held Doppler, color Doppler ultrasound, or plethysmography. There are many pitfalls in performing a prevalence study of venous leg ulcers which introduce a risk of misinterpretation of the true prevalence. Some of these pitfalls and their likely effects are presented. Based on the available and most qualitative studies the overall prevalence of venous ulcers (healed + open) is, astonishingly stable between different countries and over time, around 1% in most populations. The point prevalence of open ulcers is more variable and is likely to be in the region of 0.1-0.3% depending on whether or not people who self-treat are included.