Occurrence of lateral incompetent perforating veins of the calf. Usefulness of the posterior midline incision.
This investigation is an evaluation of the posterior approach for subfascial ligation of incompetent perforating veins (IPV) of the calf. The distribution of veins found incompetent at operation and the incidence of wound complications were studied. 39 patients with clinical multiple perforating vein insufficiency were operated on. At the end of the operation the crural fascia was sutured in half of them. The tissue pressure in the gastrocnemius muscle was measured in 13 patients postoperatively. 151 IPVs were found in the 39 legs operated on (3.8/ leg). 25% were found on the lateral side, and were inaccessible from a medial incision. Postoperative infection was noted in 3 patients and in a further 6 mostly minor skin necrosis with delayed healing occurred. The incidence of delayed healing was not influenced by fascia suture and the tissue pressure was normal in the 13 patients so examined. The posterior incision gives excellent access to both medial and lateral IPVs and makes possible resection of the short saphenous vein at the same time. This approach is useful when ulcers and stasis dermatitis are present on both medial and lateral sides or when there are medial IPVs and signs of incompetence of the short saphenous vein.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D013530:Surgical Wound Infection; D013537:Sutures; D014647:Varicose Ulcer / Q000601:surgery; D014648:Varicose Veins / Q000453:epidemiology / Q000601:surgery*