THE NEW ZEALAND MEDICAL JOURNAL Vol 115 No 1156 ISSN 1175 8716 Leg ulcers in New Zealand: age at onset, recurrence and provision of care in an urban population Natalie Walker, Anthony Rodgers, Nicholas Birchall, Robyn Norton, Stephen MacMahon. Abstract Aim To describe the age at onset, recurrence rate, and provision of care for people with leg ulcers in New Zealand. Methods Between 1997 and 1998, people with current leg ulcers were identified from the North Auckland and Central Auckland health districts via notification from relevant health professionals and by self-referral. All ulcer types were investigated. Identified cases, aged between 40 and 99 years and on the general electoral roll, were interviewed as part of a case-control study. Descriptive information relating to interviewed cases is presented. Results 241 people with leg ulcers were interviewed. The average age was 75 years and almost 60% were women. The average age at ulcer onset was 65 years, 59% of people had recurrent ulcers, and 24% had been hospitalised in the last five years because of their leg ulcers. Those people with recurrent leg ulcers had lived with their condition for an average of fifteen years, with an average time to healing for their last ulcer of thirteen months. Treatment of this condition was largely community-based, with 136 different treatment options employed. Conclusions Leg ulceration remains a chronic and recurring condition, with substantial practice variation in terms of treatment. Urgent attention needs to be given to the management of leg ulcer patients in this country, particularly given that New Zealand has a rapidly ageing population. Leg ulcers primarily affect people aged 65 years and over. 1-4 Although a number of studies have been conducted on the burden of illness associated with the condition, results are not directly comparable due to a variety of methodological problems. In particular, the studies vary with respect to case definition, the type of population, the type of ulcers, and the age groups investigated. This is partly why reported occurrence varies greatly between countries. Given this variability, it was considered appropriate to investigate leg ulcer patients in a New Zealand setting. Descriptive data about leg ulcers (including ulcer frequency, ulcer location, age at onset, and recurrence) would give an indication of the potential benefits from improvements in treatment. Data on the types of care patients receive would help delineate major areas of practice variation, and hence clinical uncertainty. This paper presents the results of this research. Methods The Auckland Leg Ulcer Study involved the identification and interview of people suffering from leg ulceration. A leg ulcer was defined as any break in the skin on the leg (below the knee) or on the foot, which had been present for more than six weeks. People of all ages were included in the study, NZMJ 21 June 2002, Vol 115 No 1156 Page 1 of 8 http://www.nzma.org.nz/journal/ © NZMA