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Leg ulcer recurrence and its risk factors: a duplex ultrasound study before and after vein surgery

M B Magnusson1, O Nelzén, R Volkmann

  • 1Department of Clinical Physiology, Cardiovascular Institute, Göteborg, Sweden. marie.magnusson@vgregion.se

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|June 6, 2006
PubMed

Insights

Varicose vein surgery can reduce chronic leg ulcer recurrence. Eliminating incompetent veins lowers risk, while residual reflux increases it, highlighting the importance of postoperative assessment for identifying high-risk patients.

Area of Science:

  • Vascular Surgery
  • Dermatology
  • Phlebology

Background:

  • Chronic leg ulcers often stem from venous insufficiency.
  • Recurrence is a significant challenge in managing these ulcers.
  • Varicose vein surgery is a treatment option, but risk factors for recurrence need identification.

Purpose of the Study:

  • To identify risk factors for chronic leg ulcer recurrence after varicose vein surgery.
  • To assess the effectiveness of postoperative investigations in predicting recurrence.

Main Methods:

  • Retrospective follow-up study of 62 patients (CEAP C(5)-C(6), E(P)) undergoing varicose vein surgery.
  • Pre- and postoperative colour duplex ultrasound (CDU) and ambulatory venous pressure (AVP) measurements.
  • Median follow-up of 5.5 years.

Main Results:

  • The 5-year ulcer recurrence rate was 19%.
  • Lower recurrence risk was observed in legs without residual varices or reflux.
  • Key risk factors identified included time to surgery, postoperative venous axial reflux, and AVP.

Conclusions:

  • A long ulcer history is a risk factor for recurrence.
  • Complete elimination of incompetent veins reduces recurrence risk; residual reflux increases it.
  • Postoperative CDU effectively identifies patients at risk for ulcer recurrence.
Abstract

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