title: Total superficial vein reflux eradication in the treatment of venous ulcer.
abstract: Total superficial vein reflux eradication in the treatment of venous ulcer.
  
  
  BACKGROUND
  Our initial experience with groin-knee vein stripping resulted in recurrent or unhealed venous ulcers prompting us to remove the entire reflux segment with emphasis on the calf superficial vein adjacent to, or underneath the ulcer. This study aims to assess the healing and recurrent rates after treatment with this technique combined with compression therapy.
  
  
  METHODS
  Pertinent data of the patients with healed or active venous ulcers (C5-6) between October 2006 and October 2013 was prospectively collected and retrospectively reviewed.
  
  
  RESULTS
  Forty-three operations were performed on 39 C5-6 legs (four reoperations for recurrent ulcer of the same legs) among 35 patients who had completed follow-up. The median follow-up time was 22 months. Of the 39 operations for active venous ulcers (C6), wound healing was achieved in 35 instances (90 %) with a median healing time of 21 days. The 30-day healing rate was 64 % and the 14-day healing rate was 38 %. Only four legs had ulcers which healed beyond 60 days. The post-operative VCSS and VDS were significantly improved compared with the pre-operative value (11.6, 3.7, p < 0.0001 and 1.0, 0.7, p = 0.035 for VCSS and VDS, respectively). Recurrent ulceration was found in four legs. The 2- and 6-year recurrence rates were three percent and 22 percent, respectively.
  
  
  CONCLUSIONS
  Venous ulcer could be satisfactory treated by the total removal of the peri-ulcer reflux.
authors: Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsain Rd. Dusit, Bangkok, 10300, Thailand, burapa04@icloud.com.
authors: Burapa
authors: B
authors: Kanchanabat
authors: Waigoon
authors: W
authors: Stapanavatr
authors: Pong
authors: P
authors: Kanchanasuttiruk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000601:surgery*; D014945:Wound Healing