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Surgical treatment for venous ulcers: is it worthwhile?
J M Dunn1, E J Cosford, V F Kernick
1Royal Devon & Exeter Hospital, Wonford.
Annals of the Royal College of Surgeons of England
|November 1, 1995
Summary
Surgical intervention for venous ulcers, including superficial vein surgery and arterial reconstruction, significantly improves healing rates and pain relief compared to non-operative treatments. Appropriate surgical management is key for effective venous ulcer care.
Area of Science:
- Vascular Surgery
- Dermatology
- Wound Healing
Background:
- Venous ulcers are a common and debilitating condition, often associated with severe pain and long-term presence.
- Effective treatment strategies for venous ulcers are crucial for improving patient outcomes and quality of life.
Purpose of the Study:
- To evaluate the effectiveness of surgical interventions versus non-operative management for venous ulcers.
- To assess the impact of venous and arterial surgery on ulcer healing and pain relief.
Main Methods:
- A review of 159 consecutive limbs with venous ulcers in 140 patients.
- Clinical evaluation, Doppler ultrasound, venography, photoplethysmography, arteriography, and duplex scanning were utilized.
- Treatment modalities included superficial venous surgery, arterial reconstruction, and skin grafting, alongside non-operative approaches.
Main Results:
- Surgical treatment achieved an 88% healing rate, compared to 52% for non-operative management.
- Ulcer recurrence was 18% in both surgical and non-operative groups.
- Operative mortality was low, with one death after arterial reconstruction and none after venous surgery.
Conclusions:
- Appropriate venous and arterial surgery demonstrates a favorable association with venous ulcer healing and pain relief.
- A policy of thorough patient evaluation and tailored surgical treatment is supported for managing venous ulcers.