Role of superficial venous surgery in the treatment of venous ulceration

Bello, Mariana De Carlo; Scriven, M.; Hartshorne, T.; Bell, P. R. F.; Naylor, A.R.; London, N. J. M.

doi:10.1046/j.1365-2168.1999.01155.x

Cited by 99 publications

(56 citation statements)

References 18 publications

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“…Most investigators have favored correction of the superficial reflux initially by removing or ablating the refluxing saphenous veins and tributaries, since these procedures are relatively simple and effective and will heal many venous ulcers. 2,11,12 When superficial ablation does not result in venous ulcer healing, perforator interruption is usually the next step. Whether it is done with direct surgery, sclerotherapy, subfascial endoscopic perforator surgery (SEPS), or endovenous ablation, the elimination of perforator reflux reduces ambulatory venous hypertension.…”

Section: Discussionmentioning

confidence: 99%

Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers

Lawrence

Alktaifi

Rigberg

et al. 2011

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers

Lawrence

Alktaifi

Rigberg

et al. 2011

Journal of Vascular Surgery

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“…difficult to perform in this field; 4) Bauer's [5] dogma, according to which vein ulcers are mostly sequelae of deep vein thrombosis (DVT), has had a long career, although it has been established that half of all these cases result from primary saphenous varicose veins or incompetent distal perforators [6]; and 5) appropriate treatment for large trunk varicose veins reduces the patient's risk of developing trophic changes and results in rapid healing of venous ulcers due to saphenous vein insufficiency [7,8].…”

Section: Opinion Statementmentioning

confidence: 99%

Current treatment of varicose veins

Becker

2006

Curr Treat Options Cardio Med

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Varicose veins (VVs) of the lower limbs are a common complaint that can take many forms, ranging from a nonpathologic condition to an invalidating chronic disorder. When they have not been neglected, uncomplicated VVs have often been treated by sclerotherapy or surgery, with variably successful results. Currently, the best way of assessing VVs has been to carry out routine ultrasound investigations. The approach to VVs has changed due to recent awareness of cosmetic considerations and the way they can affect quality of life, as well as the development of new treatments (ie, echo-guided sclerotherapy, foam sclerotherapy, endovascular obliteration) and ambulatory care practices. In some cases, the evolution of the disease can be disconcerting, if not entirely hopeless. However, in most cases, poor results have been obtained because of perfunctory assessment, inappropriate treatment, and lack of follow-up. The treatment of complicated VVs has been improved by combining clinical and ultrasound examinations, which make for a quick, accurate diagnosis, pointing the way to the right treatment. Venous ulcers resulting from primary saphenous vein insufficiency, which account for 50% of all venous ulcers, and recurrent venous ulcers should all be a thing of the past, apart from those associated with deep valvular insufficiency disease. The quality of care and the scientific standard of clinical studies on chronic venous insufficiency and VVs have both increased considerably. Although there is still a need to set up scales for assessing symptoms and quality of life, progress is being made in clinical studies that now meet the standards of evidence-based medicine.

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“…Superficial venous surgery may have a role in the treatment of venous ulcers associated with isolated superficial incompetence [4,15]. A recent, randomized, controlled trial evaluated the effects of surgery and compression, versus compression alone, on healing and recurrence, in ulcerated or recently healed legs of 500 patients.…”

Section: Venous Surgerymentioning

confidence: 99%

Treatment of venous ulcers

Araujo

Hexsel²,

Kirsner

2005

Curr Treat Options Cardio Med

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Underlying the pathogenesis of venous ulceration is venous hypertension. Therefore, the use of multilayered compression therapy is the gold standard in the treatment of a venous ulcer. As treatment progresses, an important determinant of response is wound assessment, which should be performed on initial visit and subsequently thereafter. Among the methods to assess improvement are digital photography and planimetry, which are objective methods to measure response to treatment and rate of wound healing. Lack of improvement over a 2- to 4-week period is predictive of eventual lack of response to therapy and suggests the need for adjunctive methods to achieve success, such as oral pentoxifylline, tissue-engineered skin, or skin grafting.

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Role of superficial venous surgery in the treatment of venous ulceration

Abstract: In patients with venous ulceration and isolated superficial venous incompetence, superficial venous surgery can produce ulcer healing in the majority of patients without the need for perforator surgery, postoperative compression bandaging or skin grafting.

Cited by 99 publications

References 18 publications

Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers

Endovenous ablation of incompetent perforating veins is effective treatment for recalcitrant venous ulcers

Current treatment of varicose veins

Treatment of venous ulcers

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