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["Difficult" venous ulcers of the legs]
S Mordente1, G Pacca, A Guarino
1Cattedra di Chirurgia Generale, IIa Università degli Studi di Napoli.
Chirurgia Italiana
|June 9, 2001
Summary
This study analyzed critical venous leg ulcers in 200 patients. Aggressive medical and surgical treatments, including oxygen therapy and skin grafts, showed promising results in healing these complex leg ulcers.
Area of Science:
- Vascular Surgery
- Dermatology
- Wound Healing
Background:
- Venous leg ulcers are chronic wounds impacting quality of life.
- Critical venous leg ulcers present unique management challenges.
- Accurate diagnosis is crucial for effective treatment of lower limb trophic lesions.
Purpose of the Study:
- To analyze diagnostic and surgical criteria for critical venous leg ulcers.
- To evaluate the effectiveness of a combined medical and surgical approach.
- To assess healing times and complication rates in critical venous leg ulcer management.
Main Methods:
- Ultrasonography and echocolor Doppler for diagnosis of venous leg ulcers.
- Aggressive surgical debridement and medical management.
- Oxygen therapy and mesh skin grafting for non-healing ulcers.
Main Results:
- Critical venous leg ulcers identified in 19% of patients.
- Complete epithelialization occurred in 21.7% post-surgery.
- Oxygen therapy (56.6%) and skin grafts (21.7%) were utilized, with a mean healing time of 12 days with oxygen therapy.
- Low recurrence rate (4.3%) observed at one year.
Conclusions:
- A correct etiological diagnosis is paramount in managing critical venous leg ulcers.
- The described treatment protocol reduces healing time and social costs.
- The combined approach is effective with minimal complications for critical venous leg ulcer patients.