Flush ligation and compression sclerotherapy for the control of venous disease

Tailoring treatment to the individual limb, by using flush ligation for the incompetent long saphenous vein and compression sclerotherapy for perforating veins and major control points, gives good control of venous disease. The long saphenous vein can be preserved in these circumstances. Compression sclerotherapy is easily repeated if necessary. Varicography and local ligation should be considered for large recurrences in the thigh where compression sclerotherapy is difficult. Compression sclerotherapy has replaced fasciotomy in my practice, and I strongly recommend this combined approach to surgeons interested in the treatment of venous disease.