Long-term mortality of ultrasound structure in patients with venous leg ulcers-healed from one week to twenty years

Objective To obtain information about the quality of scars of healed venous leg ulcers compared with intact skin on the opposite leg by using high-frequency ultrasound. Methods Twenty-eight patients (16 women, 12 men, aged 31-89 years) whose venous ulcers had healed and scars formed were included in this study. The echogenicities of scars were measured with a 20 MHz high-frequency ultrasound Dermascan. The thickness of epidermis and dermis was assessed and the number of low echogenic pixels (LEPs) in the papillary dermis and reticular dermis were counted using image analysis software.Results The average epidermal thickness of the scars after 1 week to 20 years of healing was significantly increased compared to those of the control (P<0.01), whereas the average dermal thickness of scars after healing was significantly decreased compared to the control (P<0.01). The numbers of LEPs and the distributions of LEPs between scars and controls had no statistically significant differences. There were no correlations among scar echogenicities, age of healed venous ulcers, initial ulcer areas, age of venous ulcers or age of patients. In the control skin samples, the young group aged 31-69 years had fewer LEPs than did the elderly group aged 70-89 years.Conclusion Our study demonstrates that after the healing of venous leg ulcers, there are significant differences in the thickness of the epidermis and dermis, but no significant alterations in water content and distribution in the dermis when compared to the controls.