Retrograde Venous Perfusion Augments Healing of Chronic Venous Leg Ulcers: A Randomized Controlled Trial

Venous leg ulcers (VLUs) cause a significant health care burden due to high health care costs, prolonged treatment, and high recurrence. Our study aims to compare between retrograde venous perfusion (RVP) combined with conventional therapy versus conventional therapy for treatment of chronic VLUs with regard to safety and efficacy. Drugs used for RVP were prostaglandin E1 (alprostadil), calcium heparin, hydrocortisone, pheniramine maleate, and lidocaine. This was a randomized controlled study conducted on 60 patients with chronic VLUs from June 2023 to June 2024. Patients were divided into two groups: RVP with conventional therapy versus conventional therapy only. Outcomes included the rate of complete ulcer closure and the percentage of healing at 6 months, ulcer-related complications, and recurrence rates. At 6 months, the RVP with conventional therapy group had a significantly higher ulcer surface area reduction, 83.7% versus 61%, p = 0.001, and a higher percentage of complete healing, 86.2% versus 44.8%, p = 0.005, as compared to the conventional therapy alone group. Similarly, time to complete healing was shorter in the RVP group at 7.8 ± 2.61 weeks versus 10.7 ± 4.31 weeks, p < 0.001. There was no significant difference in rates of wound infection between the two groups. Lower, though statistically non-significant, recurrence rates were seen within the RVP group: 8% versus 15.4%. RVP should be considered one of the adjunctive treatments for chronic VLUs. It offered positive results with regard to improved healing outcomes and reduced ulcer size. More researches are needed to confirm these conclusions.