Abstract
INTRODUCTION
Most leg ulcers are caused by venous disease, the most common cause of venous hypertension being superficial vein incompetence. The ESCHAR trial tested the value of superficial vein surgery combined with compression in the healing and recurrence of venous leg ulcers compared with compression alone.
METHODS
A total of 500 patients with chronic venous leg ulcers, or recently healed ulcers, were randomized to superficial vein surgery and compression or compression alone. Vein surgery was saphenofemoral ligation and great saphenous stripping and phlebectomy or saphenopopliteal ligation and phlebectomy.
RESULTS
Ulcer healing was virtually identical between the 2 groups at 65% at 24 weeks; subgroup analysis failed to show a benefit for surgery to promote ulcer healing. Ulcer recurrence rate was halved in those that underwent surgery regardless of the presence of deep vein incompetence.
CONCLUSION
Superficial vein surgery should be considered in all leg ulcer sufferers to reduce ulcer recurrence rather than accelerate ulcer healing.
TY - JOUR
T1 - The ESCHAR trial: should it change practice?
A1 - Wright,David D I,
Y1 - 2009/07/14/
PY - 2009/7/16/entrez
PY - 2009/7/16/pubmed
PY - 2009/11/6/medline
SP - 69
EP - 72
JF - Perspectives in vascular surgery and endovascular therapy
JO - Perspect Vasc Surg Endovasc Ther
VL - 21
IS - 2
N2 - INTRODUCTION: Most leg ulcers are caused by venous disease, the most common cause of venous hypertension being superficial vein incompetence. The ESCHAR trial tested the value of superficial vein surgery combined with compression in the healing and recurrence of venous leg ulcers compared with compression alone. METHODS: A total of 500 patients with chronic venous leg ulcers, or recently healed ulcers, were randomized to superficial vein surgery and compression or compression alone. Vein surgery was saphenofemoral ligation and great saphenous stripping and phlebectomy or saphenopopliteal ligation and phlebectomy. RESULTS: Ulcer healing was virtually identical between the 2 groups at 65% at 24 weeks; subgroup analysis failed to show a benefit for surgery to promote ulcer healing. Ulcer recurrence rate was halved in those that underwent surgery regardless of the presence of deep vein incompetence. CONCLUSION: Superficial vein surgery should be considered in all leg ulcer sufferers to reduce ulcer recurrence rather than accelerate ulcer healing.
SN - 1531-0035
UR - https://www.unboundmedicine.com/medline/citation/19602507/The_ESCHAR_trial:_should_it_change_practice
L2 - https://medlineplus.gov/leginjuriesanddisorders.html
DB - PRIME
DP - Unbound Medicine
ER -