Effectiveness of the Use of the Human Recombinant Epidermal Growth Factor in the Subsidized Regime vs The Contributive Regime in Patients with Venous Ulcers in Bogotá.

Introduction: Vascular ulcers constitute a serious global public health problem, responsible for causing a significant social and economic impact due to their recurrent, disabling nature and the need for prolonged therapies to cure them. Objective: To evaluate the use and efficacy of the rhEGF in the epithelialization of patients with a diagnosis of CEAP stage 6 venous insufficiency, in the two regimes of the health system in Colombia, the contributive (equivalent to a health system where citizens with payment capacity contribute a percentage of their salary) and the subsidized (equivalent to a health system where the state covers the vulnerable population and low socioeconomic level) versus the other treatments used. Methodology: Observational, descriptive, retrospective, multicenter study, in which 105 medical records with 139 ulcers were reviewed, in 2 centers, one belonging to the subsidized system and the other to the contributive system in Colombia. Results: The association with the epithelialization variable of the different treatment groups for ulcers according to the application of the mixed effect model test, for both regimes was for the Biologicals (EC 34.401/p = 0.000), Bioactive Agents (Hydrogels) (EC 24.735/p = 0.005) groups; for the rest of the treatment groups, the results were neither associated nor statistically significant. Conclusion: Intra- and perilesional therapy with rhEGF expands the therapeutic spectrum in patients with venous ulcers, regardless of the type of health system in which it will be applied, shortening the healing time and reaching a possible therapeutic goal, which according to this study there is an association with epithelialization regardless of the regime applied.

Socio-Demographic Characteristics and Associated Factors of Morbidity in Patients with Venous Ulcers Treated in Two Institutions of Contributive and Subsidized Regime in Colombia: Retrospective, Multicenter, Observational Study.

Aim: Venous ulcers are the most serious complication of chronic venous insufficiency secondary to venous hypertension and represent between 80% and 90% of all ulcers vascular, having socioeconomic repercussions and on the patient's quality of life. Objective: To determine the factors associated and complications with the morbidity of patients with venous ulcers CEAP 6 in two health delivery systems in Colombia. Methodology: Observational study retrospective multicenter carried out in two health centers, one under the subsidized scheme and the other under the contributory scheme in patients captured adults over 18 years of age during the years 2018 and 2019 with a diagnosis of chronic venous insufficiency CEAP 6 performing a review to the clinical history up to 4 years before the consultation for vascular surgery of ulcerative pathology. Results: A total of 105 patients were evaluated 52% of the contributory regime and 48% patients of the subsidized regime. With 139 ulcers, 70% were women. The educational level of the population in 77% of the individuals had no schooling or only had primary education. The patients of the subsidized regime belonged to the low socioeconomic stratum vs the middle-class stratum in the contributory regime. 80.5% of the lesions are concentrated in groups less than 25 cm and 19.4% of the cases are located above 50 cm. Dressings and advanced technologies were used in 30.02% of the patients in the contributory scheme compared to 24.35% in the subsidized scheme. 37% of the subsidized scheme had contagion vs 28% of the contributory scheme. The epithelialization rates were 67.27% in the contributory regime compared to 26% in the subsidized regime. Conclusion: The prognostic factors that favor wound epithelialization are related to ulcers smaller than 25 cm, lesion evolution time under 36 months, having been managed with dressings and other advanced technologies, and belonging to the contributory regime.