Comparison of surgical modalities in the treatment of recurrent venous ulcer

Abstract

Recurrent leg ulcer secondary to superficial and deep venous valve incompetence that are refractory to non-surgical treatment can be healed with the following surgical modalities. Perforator ligation and saphenous vein stripping (PLSVS) healed 4/16 (25%) of the ulcer. PLSVS and correction of deep venous valve incompetence healed 14/16 (87.5%) of the ulcer (p less than 0.005). The mean follow-up was 32 months (8-62 mon). This prospective comparison of the 2 surgical treatments (PLSVS versus PLSVS and correction of deep venous valve) demonstrated that disassociation of the superficial from the deep venous system with PLSVS and correction of the deep valve (valvuloplasty, transposition or valve transplant) produced promising results in the treatment of recurrent venous ulcer. Adjunctive usage of elastic stocking and intermittent compression pneumatic boot to reduce swelling in the paraoperative period improved long term result in venous reconstructive surgery.