Influence of perforating vein surgery in patients with venous ulceration

Phlebology
Wb van Gent, Cha Wittens

Abstract

The exact role of perforating vein surgery is still unclear. The aim of this study is to analyze the influence of perforating vein surgery in patients with venous ulceration. This study was part of a randomized controlled trial in which conservative and surgical treatment of venous ulceration was compared. It is a secondary analysis of prospectively gathered data. Ninety-seven active leg ulcers were surgically treated with a subfascial endoscopic perforating vein surgery (SEPS) procedure. Concomitant superficial venous incompetence was treated with flush saphenopopliteal ligation and/or saphenofemoral ligation and limited stripping of the great saphenous vein. All patients were also treated with ambulatory compression therapy. Ulcer healing and recurrences are described in detail. To measure the completeness of the SEPS procedure duplex ultrasonography was performed on each patient before and 6 weeks and 12 months after surgery. Also newly formed perforators after surgery were scored and their influence was analyzed. Analyses were performed on 94 ulcerated legs with a mean follow-up of 29 months. In all treated legs, only 45% all perforators were treated. In 55% one (29%) or more (26%) perforators were missed. Healing was not s...Continue Reading

References

Jun 1, 1995·American Journal of Surgery·N LabropoulosA N Nicolaides
Jun 26, 2003·The Surgical Clinics of North America·Manju Kalra, Peter Gloviczki
Sep 5, 2006·Journal of Vascular Surgery·Wijnand B van GentCees H Wittens
Aug 25, 2007·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·O Nelzén, I Fransson
Feb 2, 2010·Phlebology·T F O'Donnell
Nov 16, 2010·BMJ : British Medical Journal·Wijnand Bert van GentCees Wittens

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