Venous ulceration and saphenous ligation

Area of Science:

• Vascular Surgery
• Phlebology
• Dermatology

Background:

• Venous ulcers represent a significant clinical challenge, often linked to complex venous pathologies.
• Classifying venous ulcer etiology is crucial for effective treatment strategies.

Purpose of the Study:

• To investigate the efficacy of saphenous ligation as a standalone treatment for Type II venous ulcers.
• To determine the medium-term healing rates in patients with combined saphenous and ankle perforator incompetence.

Main Methods:

• Prospective study of 213 patients with venous ulceration over 8 years.
• Classification of venous abnormalities using clinical examination, Doppler ultrasound, and venography.
• Treatment analysis focused on Type II patients (saphenous and ankle perforator incompetence) treated with saphenous ligation alone.

Main Results:

• Type II venous ulcers, characterized by combined saphenous and ankle perforator incompetence, accounted for 39% of the study cohort.
• Saphenous ligation alone resulted in sustained ulcer healing in over 90% of Type II patients.
• Mean follow-up period was 3.5 years, with only five cases of failed healing attributed to other factors.

Conclusions:

• Approximately 40% of venous ulcers stem from combined saphenous and ankle perforator vein incompetence.
• Saphenous ligation is a highly effective and durable treatment for this specific subgroup of venous ulcers.
• This minimally invasive approach offers a high success rate for medium-term venous ulcer healing.