title: Study on the efficacy of surgery of the superficial venous system and of compression therapy at early stages of chronic venous disease for the prevention of chronic venous ulceration.
abstract: The mainstay of treatment of chronic venous ulceration (CVU), as also suggested by current treatment guidelines for chronic venous disease (CVD), is represented by surgery and compression therapy for which there is strong evidence of their role in clinically relevant improvement in wound healing and also in the reduction of CVU recurrence, but no information is available as to whether or not these treatments provide effective protection from the onset of CVU. In our study, we have followed, for a median time of 13 years, a total of 3947 patients with CVD at classes C2-C3 of CEAP classification, treated with our treatment protocol (surgery and compression therapy) in order to track the natural history of these patients with regards to CVU development. We identified four groups of patients: 2354 patients (59·64%) (Group A) fully adherent to protocols; 848 patients (21·48%) (Group B) fully adherent to surgery and non-compliant to compression therapy; 432 patients (10·95%) (Group C) fully adherent to compression therapy and non-compliant to surgery; and 313 patients (7·93%) (Group D) non-compliant to either treatments. Regardless of compliance to treatments, the ulcer development rates were very similar between groups (range: 3·23-4.79%), with no statistical significance (P = 0·1522). Currents treatments used in the early stages of CVD appear to have no effects to progression to CVU. Additional longitudinal studies are required to confirm these findings.
authors.affiliation: Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
authors.affiliation: Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Butrico
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barbetta
authors.affiliation: Department of Dentistry and Medical and Surgical Experimental Sciences, University of Messina, Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Caridi
authors.affiliation: Department of Dentistry and Medical and Surgical Experimental Sciences, University of Messina, Messina, Italy.
authors.forename: Mafalda
authors.initials: M
authors.lastname: Massara
authors.affiliation: Division of Vascular Surgery, S. Anna Hospital, Catanzaro, Italy.
authors.forename: Francesco G
authors.initials: FG
authors.lastname: Caliò
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hospital of Saint-Flour, Saint-Flour, France.
authors.forename: Chiara
authors.initials: C
authors.lastname: Longo
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Dardano
authors.affiliation: Division of Vascular Surgery, S. Anna Hospital, Catanzaro, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cannistrà
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.|Division of Vascular Surgery, S. Anna Hospital, Catanzaro, Italy.
authors.forename: Gianluca
authors.identifier: http://orcid.org/0000-0002-6998-5405
authors.initials: G
authors.lastname: Buffone
authors.affiliation: Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D003131:Combined Modality Therapy; D058128:Compression Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods; D014945:Wound Healing / Q000502:physiology*
keywords: Chronic venous disease; Chronic venous ulceration; Compression therapy; Surgery