Chronic venous leg ulcers benefit from surgery: Long-term results from 173 legs

Abstract

On the basis of the results from the 7 years of data from functional surgery of venous leg ulcers and as a result of the outcomes of our study, we recommend surgical treatment of venous leg ulcers at any stage. We therefore conclude that surgery is indicated before an ulcer is intractable to treatment. In general, our findings are based on the understanding and identification of the causes and symptoms of venous ulceration and illustrate that standard surgical methods can be applied for the therapy of venous leg ulcers at any stage.

Identifying the source of superficial reflux in venous leg ulcers using duplex ultrasound

“…7 Abolition of superficial refluxes has been shown to achieve beneficial effects on ulcer healing even in the presence of concomitant deep venous refluxes and can be offered on a general basis. 8,9 In this study, we sought to identify the exact reflux routes associated with medially or laterally located venous leg ulcers. To achieve this aim, we prospectively investigated 183 legs with active leg ulcers presenting with venous reflux, using extended duplex ultrasound examination focusing on the ultimately dominant venous reflux routes in addition to classical venous mapping.…”

Authors’ own method of diathermic thermal ablation of venous perforators – surgery with protective tumescence

“…Even if their clinical meaning is still under debate [17][18][19], their closure in patients presenting with severe venous insufficiency, such as class C5 and C6 according to the CEAP classification, significantly contributes to better results of treatment [20][21][22][23][24][25][26][27][28]. Incompetence of perforating veins can be of primary or secondary nature.…”

The Study, Clinical Implications and Solutions for Failed Varicose Vein Surgery With Recurrent Venous Ulcers: An Analysis of 12 Patients With Duplex Scan Correlated With Intra Operative Findings at Second Surgery

“…Even though endovenous laser treatment is an advance in the minimized surgical approach, it can never fully displace accepted surgical procedures. [15] Anatomical failures are to be recognized in endovenous ablations procedures and should be combined with open surgery.…”

“…Other studies have shown one year recurrence of 25% and 3 year recurrence of 38%. [14] [15] Previous studies have failed to show a benefit from superficial venous surgery in terms of haemodynamic change or ulcer healing in patients with mixed deep and superficial reflux. [16] They had included primary varicose ulcer procedures and ulcers associated with deep venous insufficiency and postthrombotic legs.…”