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Management of venous ulcers according to their anatomical relationship with varicose veins

Yun-Nan Lin1, Tung-Ying Hsieh1, Shu-Hung Huang1

  • 11 Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Phlebology
|January 7, 2017
PubMed

Insights

Endoscopic-assisted surgery effectively removes varicose and incompetent perforating veins, leading to high healing rates for venous ulcers. This minimally invasive approach significantly reduces long-term recurrence, improving patient satisfaction.

Area of Science:

  • Vascular Surgery
  • Minimally Invasive Procedures
  • Wound Healing

Background:

  • Recurrence of venous ulcers is often linked to inadequate excision of varicose and incompetent perforating veins.
  • Effective surgical management is crucial for improving healing outcomes and reducing ulcer recurrence.

Purpose of the Study:

  • To evaluate the efficacy of endoscopic-assisted surgery for excising varicose and incompetent perforating veins in patients with venous ulcers.
  • To assess the healing rates, recurrence rates, and patient satisfaction following this surgical technique.

Main Methods:

  • A cohort of 66 venous ulcers across 1083 legs with primary varicose veins were treated using endoscopic-assisted surgery.
  • Endoscopic visualization allowed for precise identification, dissection, and complete excision of target veins.
  • Kaplan-Meier analysis was used to determine long-term recurrence rates.

Main Results:

  • Varicose veins feeding the ulcers were identified and excised in 55 cases.
  • A significant healing rate of 89.4% was observed within 14 weeks.
  • The study reported a 0.0% five-year recurrence rate and a high patient satisfaction score (mean 4.6).

Conclusions:

  • Endoscopic-assisted surgery provides radical excision of problematic veins in complex venous ulcers.
  • This technique demonstrates excellent outcomes, including low recurrence rates and high patient satisfaction.
  • It represents a viable and effective surgical option for managing varicose veins associated with venous ulcers.

Keywords:
Anatomyendoscopic surgeryvaricose veinsvenous ulceration

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