title: The combined algorithm of venous ulcer therapy.
abstract: OBJECTIVE
  This prospective study was undertaken to find a new combined algorithm to help patients suffering from long-term chronic non-healing venous ulcers.
  
  
  METHODS
  A total number of 20 patients suffering from chronic venous ulcers and important co-morbidities such as diabetes mellitus or cardiac failure and not responding to other therapeutic modalities were treated at our surgical department with a combination of compressive sclerotherapy, and maggot debridement therapy (MDT) using larvae of green blowfly Lucilia sericata.
  
  
  RESULTS
  Using the combined therapy we have achieved a significant clinical effect in 19 patients (95 %). In 1 patient, this effect was only impermanent while 5 patients (25 %) were completely cured. Eleven patients (55 %) benefited despite incomplete healing of the ulcer. With three of our patients we have lost contact.
  
  
  CONCLUSIONS
  Even though the number of patients in our study is not large, we have achieved remarkable results with the combined algorithm of venous ulcer therapy. We start the healing process with compressive sclerotherapy and when this kind of therapy does not bring about the expected effect, we continue with Maggot debridement therapy. This combination of therapeutic modalities appears to be very effective and efficient (Fig. 2, Ref. 16).
authors.affiliation: 1st Department of Surgery, University Hospital, Bratislava, Slovakia. mcambal@zoznam.sk
authors.forename: M
authors.initials: M
authors.lastname: Cambal
authors.forename: P
authors.initials: P
authors.lastname: Labas
authors.forename: P
authors.initials: P
authors.lastname: Zonca
authors.forename: B
authors.initials: B
authors.lastname: Hrbaty
authors.forename: M
authors.initials: M
authors.lastname: Janik
authors.forename: S
authors.initials: S
authors.lastname: Polakovicova
mesh_terms: D000368:Aged; D000818:Animals; D003131:Combined Modality Therapy; D058128:Compression Bandages; D003646:Debridement; D005260:Female; D006801:Humans; D007814:Larva; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy; D014647:Varicose Ulcer / Q000209:etiology / Q000628:therapy*