title: Atypical leg ulcers after sclerotherapy for treatment of varicose veins: Case reports and literature review.
abstract: BACKGROUND
  Skin necrosis is a rare complication of foam sclerotherapy, a common form of treatment for varicose veins.
  
  
  METHODS
  Both patients presented to the outpatient clinic within 2-14days after foam sclerotherapy with Aethoxysklerol(®) 1%, with severe soft tissue and skin necrosis. Further aggressive treatment of the ulcer was required to resolve the necrosis, resulting in marked residual scar and well granulated leg ulcer respectively.
  
  
  CONCLUSIONS
  Foam sclerotherapy is a common and usually well-tolerated treatment modality for varicose veins. The aetiology of skin necrosis is conventionally related to extravasation of sclerosant. In order to minimise the risk of necrosis, the lowest concentration and lowest volume of sclerosant necessary to achieve adequate treatment of the target vein should be used.
  
  
  CONCLUSIONS
  We would like to emphasise that whilst skin and soft tissue necrosis is a rare complication of foam sclerotherapy, it is a complication that is highly disfiguring and requires aggressive treatment. As such, it should be adequately discussed with the patient prior to obtaining informed consent.
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia; School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, Western Australia, Australia. Electronic address: bibombe@iinet.net.au.
authors.forename: Bibombe P
authors.initials: BP
authors.lastname: Mwipatayi
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Western
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia.
authors.forename: Jackie
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: Angel
keywords: Debridement; Foam sclerotherapy; Skin necrosis; Ulcer; Varicose veins