Surgical removal of ulcer and lipodermatosclerosis followed by split-skin grafting (shave therapy) yields good long-term results in "non-healing" venous leg ulcers.
The purpose of this study was to evaluate the long-term effects of shave therapy in non-healing venous leg ulcers. Forty-one patients with 75 recalcitrant leg ulcers caused by primary deep vein incompetence or post-thrombotic syndrome were operated by shave therapy (removal of ulcer and surrounding lipodermatosclerosis with a Schink skin-grafting knife and covering of the wounds with meshed split-thickness skin grafts). After an average follow-up period of 2 years and 5 months all patients were evaluated for long-term results. The healing rate of ulcers classified as non-healing was 67% (50 of 75 ulcers). The healing rate was 76% for ulcers associated with primary deep vein incompetence and 58% for ulcers associated with post-thrombotic syndrome (p = 0.08). Even in cases with recurrence (33%) these ulcers were strikingly reduced by 80-90% of their original size. Hypaesthesia was noticed in 38% of the transplanted areas. In "non-healing" venous leg ulcers due to deep venous insufficiency shave therapy yields favourable long-term results. Because it is only a symptomatic treatment which does not reduce the pathological refluxes, continuous compression of the lower leg is important.
Schmeller
W
W
Rosenparkklinik, Darmstadt, Germany. wilfried.schmeller@t-online.de
Gaber
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007871:Leg Ulcer / Q000601:surgery*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012594:Scleroderma, Localized / Q000601:surgery*; D016038:Skin Transplantation; D014647:Varicose Ulcer / Q000601:surgery*