A multicentre study of percentage change in venous leg ulcer area as a prognostic index of healing at 24 weeks

Sir, In regard to an article published in this journal,1 I would like to offer some corrections and comments. The article deals with ways to analyse and measure the rate at which skin wounds are closing. For clarity, I have underlined different healing rate parameters in this letter. The message sent by this article is that using percent area reduction is a good way, perhaps the best way, to measure healing progress and to predict whether a chronic venous ulcer will go on to heal. This conclusion is not supported by the published literature. In fact, it is not supported by the data and analysis of Kantor and Margolis,1 as I have learned through correspondence with the lead author. There are two erroneous themes presented in this paper that need correcting. The first is the idea that healing rate on an area basis, for example area per week reduction, is independent of the initial area of the wound. This theme is communicated to the reader in the statement ‘…no correlation was noted among any of the methods used to estimate the change in area and initial area of the wound’.1