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Eur J Vasc Endovasc Surg. 2016 Aug;52(2):225-32. doi: 10.1016/j.ejvs.2016.02.023. Epub 2016 Apr 26.

Lateral Fasciectomy Sparing the Superficial Peroneal Nerve with Simultaneous Mesh Graft in Non-healing Lateral Leg Ulcers of Diverse Vascular Origins: Surgical Technique, Short- and Long-term Results from 44 Legs.

Author information

1
Department for Functional Phlebosurgery, Karl Landsteiner Society, Himmelreichstrasse 15, 3390 Melk, Austria; Department of Surgery, St. Josef Hospital of Vienna, Auhofstraße 189, 1130 Wien, Austria.
2
Department for Functional Phlebosurgery, Karl Landsteiner Society, Himmelreichstrasse 15, 3390 Melk, Austria.
3
Department of Surgery, St. Josef Hospital of Vienna, Auhofstraße 189, 1130 Wien, Austria.
4
Research Office (Biostatistics), Paracelsus Medical University, Strubergasse 20, 5020 Salzburg, Austria.
5
Department for Functional Phlebosurgery, Karl Landsteiner Society, Himmelreichstrasse 15, 3390 Melk, Austria; Department of Surgery and Vascular Surgery, University Hospital St. Poelten, Propst-Fuehrer-Strasse 4, 3100 St. Poelten, Austria. Electronic address: ferdinand.steinbacher@gmail.com.

Abstract

OBJECTIVES:

The technique of lateral fasciectomy (LF) sparing the superficial peroneal nerve with mesh graft coverage is a novel treatment of non-healing lateral leg ulcers of various vascular origin affecting the fascia. We report short- and long-term results of LF for recalcitrant lateral leg ulcers.

DESIGN:

This study is a single center, retrospective case series of consecutive patients treated by LF.

MATERIALS:

From 827 ulcers treated at our institution, 44 recalcitrant lateral leg ulcers affecting the fascia (41 patients) underwent lateral fasciectomy between 2006 and 2013.

METHODS:

Preoperative indications, step-by-step surgical procedures, and perioperative care methodologies are presented. Long-term effects of healing and recurrence were clinically investigated or obtained through telephone interviews with relatives and local practitioners.

RESULTS:

Three discrete etiologies were identified: venous ulcers (n = 24), arterial-venous/mixed ulcers (n = 11), and arteriolar Martorell hypertensive leg ulcers (n = 9). Complete healing was achieved in 40 legs (91%) after 3 months, and in 43 of the affected legs (98%) in total. The median duration to complete healing was 64 days. There was no difference between the healing times of different etiologies. No local recurrence was observed during the follow-up period, which ranged from 1.8 to 8.7 years (median: 5.11, mean: 5.12). Twelve patients (27%) died within this period due to multimorbidity.

CONCLUSIONS:

Following lateral fasciectomy and mesh graft coverage, 43 legs (98%) healed in previously treatment resistant lateral leg ulcers.

KEYWORDS:

Fasciectomy; Lateral; Martorell; Nerve sparing; Superficial peroneal nerve; Ulcer

PMID:
27129637
DOI:
10.1016/j.ejvs.2016.02.023
[Indexed for MEDLINE]
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