Sottiurai VS.
Surgical correction of recurrent venous ulcer.
J Cardiovasc Surg (Torino) 1991 Jan-Feb;32(1):104-9

Department of Surgery, Louisiana State University Medical Center, New Orleans,
Louisiana.

Seventy-six limbs from 46 patients with comparable superficial and deep venous
valve incompetence underwent surgical correction for recurrent venous ulcers of
the leg that were refractory to various modes of nonsurgical and surgical
treatments. A follow-up of 10 to 73 months (mean = 37 months), revealed the
venous ulcer healed with perforator ligation and saphenous vein stripping in 14
of 33 (44%), stripping plus valvuloplasty 17 of 21 (80%), stripping plus vein
transposition 11 of 14 (78%) and stripping plus valve transplantation 6 of 8
(75%). In patients with incompetent deep venous valve and perforators, the
disassociation of the superficial from the deep venous system (stripping) plus
correction of the deep venous valvular incompetence (valvuloplasty, transposition
or valve transplant) produced superior results in the treatment of recurrent
venous ulcer when compared to perforator ligation and saphenous vein stripping
alone (p less than 0.005). Adjunctive usage of elastic stockings and intermittent
compression pneumatic boots in the perioperative period was helpful in
controlling leg swelling and promoting wound healing.