Abstract
Venous stasis ulcers of the lower legs are often intractable to treat. The treatment for venous stasis ulcer consists of correction of venous hypertension and soft tissue care. So a corroborative effort between vascular surgeons and dermatologists or plastic surgeons is necessary. Between January 2008 and July 2012, 20 legs of 18 patients with venous stasis ulcer underwent surgery in our department. Sixteen legs caused by primary venous insufficiency contained 12 first surgeries for varicose vein and 4 recurrences of varicose vein. Four legs caused by secondary venous insufficiency included 2 arterio-venous fistulae (the same side of a case) and 2 obliterations of deep vein. Preoperative compression therapy was conducted in all cases. Superficial vein ablation was performed in 18 legs, ulcer cleaning was performed in all legs. Fifteen legs underwent severing of incompetent perforating veins, 2 legs with direct approach and 13 legs with subfascial endoscopic perforator surgery. Foam sclerotherapy was performed in 8 legs. After the surgery, 6 legs had VAC therapy, following which 2 of them had skin grafting. All ulcers by primary venous insufficiency completely healed. Ulcers by secondary venous insufficiency doesn’t healed yet but improving. To treat this difficult lesion, vascular surgeons need to have a variety of treatment options available to them, and establish a collaborative network with dermatologists or plastic surgeons. Moreover, we have to inform doctors and general people of the pathogenesis in this disease, in order to relieve the patients.
