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[Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence].
Wien Med Wochenschr. 1994; 144(10-11):264-8.WM

Abstract

2 retrospective studies illustrate the importance of the extent of damage to the deep venous system governing the recurrence rate of stasis ulcers treated surgically. 1. In patients with recurrent venous stasis ulcerations associated with superficial varicosis of the great or lesser saphenous veins and incompetent perforators operative treatment of the varicose veins resulted in a 100% long-term healing rate of the ulcerations (5-year results). This was the case for 25 legs with venous ulcers in 229 consecutive cases operated for varicose veins. 2. In 76 patients with rebellious ulcers presenting without operable superficial varicose veins the treatment was a localized one consisting of wide and deep excision of the ulcer with ligature of underlying perforators and surrounding varicose veins. The 2-year success rate was 87% in 39 patients with intact deep veins, but only 59% in 37 patients with postphebite damage to the deep veins (p < 0.05). For 1 and 2 level deep vein disease the success rate was still high at 80%, but fell to 20% if damage to the deep veins extended to 3 or 4 levels! Thus, the degree of damage to the deep veins correlates well with the propensity to recurrence of venous ulceration following surgical treatment. Venous hypertension measured by phlebodynometry is the single most powerful predictor of success or failure of surgical treatment. Patients at risk should therefore be encouraged to wear compression stockings or hosiery to offset recurrencies.

Authors+Show Affiliations

Universitätsklinik für Thorax-, Herz-und Gefässchirurgie, Inselspitals, Bern, Schweiz.No affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

7856204

Citation

Nachbur, B, et al. "[Surgical Therapy of Ulcus Cruris. Significance of Extension of the Damage to Deep Veins for Incidence of Ulcus Cruris Recurrence]." Wiener Medizinische Wochenschrift (1946), vol. 144, no. 10-11, 1994, pp. 264-8.
Nachbur B, Blanchard M, Röthlisberger H. [Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence]. Wien Med Wochenschr. 1994;144(10-11):264-8.
Nachbur, B., Blanchard, M., & Röthlisberger, H. (1994). [Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence]. Wiener Medizinische Wochenschrift (1946), 144(10-11), 264-8.
Nachbur B, Blanchard M, Röthlisberger H. [Surgical Therapy of Ulcus Cruris. Significance of Extension of the Damage to Deep Veins for Incidence of Ulcus Cruris Recurrence]. Wien Med Wochenschr. 1994;144(10-11):264-8. PubMed PMID: 7856204.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence]. AU - Nachbur,B, AU - Blanchard,M, AU - Röthlisberger,H, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 264 EP - 8 JF - Wiener medizinische Wochenschrift (1946) JO - Wien Med Wochenschr VL - 144 IS - 10-11 N2 - 2 retrospective studies illustrate the importance of the extent of damage to the deep venous system governing the recurrence rate of stasis ulcers treated surgically. 1. In patients with recurrent venous stasis ulcerations associated with superficial varicosis of the great or lesser saphenous veins and incompetent perforators operative treatment of the varicose veins resulted in a 100% long-term healing rate of the ulcerations (5-year results). This was the case for 25 legs with venous ulcers in 229 consecutive cases operated for varicose veins. 2. In 76 patients with rebellious ulcers presenting without operable superficial varicose veins the treatment was a localized one consisting of wide and deep excision of the ulcer with ligature of underlying perforators and surrounding varicose veins. The 2-year success rate was 87% in 39 patients with intact deep veins, but only 59% in 37 patients with postphebite damage to the deep veins (p < 0.05). For 1 and 2 level deep vein disease the success rate was still high at 80%, but fell to 20% if damage to the deep veins extended to 3 or 4 levels! Thus, the degree of damage to the deep veins correlates well with the propensity to recurrence of venous ulceration following surgical treatment. Venous hypertension measured by phlebodynometry is the single most powerful predictor of success or failure of surgical treatment. Patients at risk should therefore be encouraged to wear compression stockings or hosiery to offset recurrencies. SN - 0043-5341 UR - https://www.unboundmedicine.com/medline/citation/7856204/[Surgical_therapy_of_ulcus_cruris__Significance_of_extension_of_the_damage_to_deep_veins_for_incidence_of_ulcus_cruris_recurrence]_ DB - PRIME DP - Unbound Medicine ER -