Management of venous ulcers according to their anatomical relationship with varicose veins

Phlebology. 2018 Feb;33(1):44-52. doi: 10.1177/0268355516676124. Epub 2017 Jan 6.

Abstract

Background Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer. Method In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised. Result The varicose veins were traced to the base or periphery of the 55 ulcers. Moreover, 89.4% of the ulcers healed within 14 weeks. Kaplan-Meier analysis revealed a five-year recurrence rate of 0.0%, and the satisfaction mean score was 4.6. Conclusion Endoscopic-assisted surgery can be used to radically excise varicose veins complicated with venous ulcers; the surgery yields low recurrence and high satisfaction rates.

Keywords: Anatomy; endoscopic surgery; varicose veins; venous ulceration.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy* / adverse effects
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Phlebography
  • Recurrence
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Varicose Ulcer / diagnostic imaging
  • Varicose Ulcer / pathology
  • Varicose Ulcer / surgery*
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / pathology
  • Varicose Veins / surgery*
  • Wound Healing