title: The difficult venous ulcer: case series of 177 ulcers referred for vascular surgical opinion following failure of conservative management.
abstract: Venous leg ulcers are common, chronic, debilitating, and expensive. Evidence supports use of compression bandaging, with superficial venous surgery in selected cases, but these interventions frequently fail to achieve healing. We describe a series of 152 consecutive referrals from a nurse-led specialist dermatology clinic to a vascular surgical service; a group posing particularly challenging problems. This observational study, with median follow-up of 18 months, describes outcomes in a number of important clinically identifiable subgroups. Its findings may assist service planning and discussion of the surgical role within multidisciplinary ulcer management.
authors.affiliation: Nuffield Department of Surgery, Oxford Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom. s_neequaye@ yahoo.com
authors.forename: S K
authors.initials: SK
authors.lastname: Neequaye
authors.forename: A D
authors.initials: AD
authors.lastname: Douglas
authors.forename: D
authors.initials: D
authors.lastname: Hofman
authors.forename: M
authors.initials: M
authors.lastname: Wolz
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: R
authors.initials: R
authors.lastname: Cummings
authors.forename: L
authors.initials: L
authors.lastname: Hands
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012017:Referral and Consultation; D012086:Reoperation; D015911:Sclerotherapy; D053828:Stockings, Compression; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D014656:Vascular Surgical Procedures; D014945:Wound Healing