Skin grafting followed by low-molecular-weight heparin long-term therapy in chronic venous leg ulcers.
BACKGROUND
Venous leg ulcers are responsible for more than half of lower extremity ulcerations, with an overall prevalence ranging from 0.06 to 2% in the general population.


METHODS
A total number of 120 patients with chronic venous leg ulcers (CEAP C6), secondary to primary chronic venous insufficiency, were recruited (81 F, 39 M, age range: 50-79, mean age: 64.6). All patients enrolled in this study had wounds that had failed to heal for more than 2 months and were refractory to conventional medical and physical therapy. Sixty patients (group A) underwent skin grafting followed by low-molecular-weight heparin long-term therapy. Sixty patients (group B) underwent skin grafting as sole procedure. The follow-up was of 5 years.


RESULTS
At hospital discharge, all patients had healed ulcers. In group A, at 5 years, about 90% of the ulcers remained healed. In group B, at 5 years, about 56% of the ulcers remained healed.


CONCLUSIONS
In our experience, long-term treatment with low-molecular-weight heparin seems to have improved early and late results of patients, who underwent reconstructive surgery for chronic venous ulcer; 90% of the ulcers remained healed at 5 years of follow-up. Probably, extracellular matrix-modulating treatments, such as heparin administration, may complete the management strategy for difficult-to-heal or chronic wounds.
Unit of Vascular Surgery, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Raffaele
R
Serra
Gianluca
G
Buffone
Andrea
A
de Franciscis
Diego
D
Mastrangelo
Tiziana
T
Vitagliano
Manfredi
M
Greco
Stefano
S
de Franciscis
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000187:drug effects*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight