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Eur J Vasc Endovasc Surg. 2000 Oct;20(4):363-8.

Surgical correction of isolated superficial venous reflux reduces long-term recurrence rate in chronic venous leg ulcers.

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1
Department of Vascular Surgery, Cheltenham General Hospital, Gloucestershire, UK.

Abstract

OBJECTIVES:

surgical correction of isolated superficial venous reflux in ulcerated legs may reduce short term recurrence rates but the longer term benefits are unknown.

DESIGN:

prospective non-randomised cohort study.

METHODS:

consecutive patients with chronic leg ulcers were prospectively assessed at a one-stop clinic over a 4-year period from July 1995 to July 1999. All patients with ankle brachial pressure indices (ABPI)50.85 were initially treated with weekly four-layer bandaging. Venous duplex studies in all ulcerated legs assessed venous reflux pattern with surgery being offered to all those with isolated superficial reflux, of whom 56% accepted. Patients were advised to wear class two elastic compression stockings after healing.

RESULTS:

766 legs in 669 patients were assessed. Six hundred and thirty-three legs had an ABPI50.85, 236 (39%) demonstrating isolated superficial venous reflux. Surgery was performed on 131 of these legs. Twelve and 24 week healing rates were 50% and 72% for operated legs and 62% and 74% for non-operated legs (p=0.67; Kaplan-Meier life table analysis). Recurrence rates at 1, 2 and 3 years were 14%, 20% and 26% for operated legs and 28%, 30% and 44% for non-operated legs (p=0.03; Kaplan-Meier life table analysis).

CONCLUSION:

surgical correction of superficial venous reflux in legs with chronic leg ulceration may reduce ulcer recurrence rate at 1, 2 and 3 years.

PMID:
11035968
DOI:
10.1053/ejvs.2000.1196
[Indexed for MEDLINE]
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