Venous leg ulcer recurrence is a multifactorial phenomenon associated with clinical, functional, behavioural and psychosocial characteristics, with older age, history of deep vein thrombosis, presence of sadness, non-use of preventive compression, and educational attainment associated with recurrence, and these findings support individualised, multidimensional prevention strategies.
Recurrence of venous leg ulcers within the previous 12 months occurred in 70% of participants with available data.
Older age was independently associated with venous leg ulcer recurrence within the previous 12 months.
History of deep vein thrombosis was strongly associated with venous leg ulcer recurrence within the previous 12 months.
Non-use of preventive compression was independently associated with venous leg ulcer recurrence within the previous 12 months.
Presence of sadness was independently associated with venous leg ulcer recurrence within the previous 12 months.
Recurrence within the previous 12 months was very strongly associated with higher 12-month recurrence-risk level.
Walking independently was associated with lower 12-month venous leg ulcer recurrence-risk level.
Daily skin hydration was associated with lower 12-month venous leg ulcer recurrence-risk level.
The study population was characterized by older age, high body mass index, and multiple comorbidities.
Data were analyzed using both binary logistic regression (for recurrence occurrence) and ordinal logistic regression (for recurrence-risk level).
This research suggests that venous leg ulcers — chronic wounds on the lower legs caused by poor vein function — recur very frequently, with 70% of study participants experiencing a recurrence within the past year. The study, conducted in Portugal with 208 adults (mostly older, with an average age of about 73), identified several factors linked to whether a person experienced a recurrence and how high their risk of future recurrence was. Key factors associated with having a recurrence included older age, a prior history of deep vein thrombosis (blood clots in the legs), feeling sad, not using compression garments or bandages for prevention, and lower educational attainment. Factors linked to lower future recurrence risk included being able to walk independently and moisturizing the skin daily, while having had a recurrence in the past year was by far the strongest predictor of being at high risk for another one. This research suggests that preventing venous leg ulcer recurrence is not just a medical issue but also involves a person's ability to move around, their emotional wellbeing, their self-care habits, and their understanding of preventive measures like compression therapy. People who have already had a recurrence are at dramatically higher risk of having another one, making continued monitoring and support after wound healing critically important. The strong association between not using compression and recurrence underscores how important it is for patients to adhere to this preventive treatment even after their wound has healed. The practical implication of these findings is that care programs for people with venous leg ulcers should go beyond wound treatment alone. This research suggests that effective prevention strategies need to address physical function (such as supporting mobility), emotional health (including screening for sadness or depression), skin care education, and ensuring patients understand and can use compression therapy consistently. A one-size-fits-all approach is unlikely to be sufficient; instead, individualized plans that account for each person's clinical history, lifestyle, and psychosocial situation may be more effective at reducing the high burden of recurrence in this patient population.
Gomes F, da Costa A, Nogueira P, Henriques M, Baixinho C. (2026). Factors Associated With Venous Leg Ulcer Recurrence and Recurrence Risk in Portugal: A Cross-Sectional Study Supporting the Development of an Innovative Preventive Intervention.. International wound journal. https://doi.org/10.1111/iwj.71034