VENOUS ULCER - A NEW THERAPEUTIC APPROACH

Authors

  • R.F. POPA University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • I. CAZAN University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Genoveva BAROI University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Simona CAZAN University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • G. LEFTER University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi
  • Cristina STROBESCU University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

Abstract

Trophic leg ulcer is a major health problem affecting approximately 1-2% of the population, the incidence being higher in the elderly (70-80 years). It is a multifactorial condition, but the most common cause is chronic venous insufficiency. This can be attributed to reflux in the saphenous system and calf perforator vein incompetence. These were first described by Linton, the first intervention designed to correct perforator vein incompetence bearing his name. Today Linton’s operation has been abandoned due to the large unaesthetic incision and great postoperative pain. Also, ulcer healing time is long (2 months) and recurrence rate is high. Currently a series of minimally invasive procedures are used to close these perforator veins, such as ultrasound-guided sclerotherapy. The advantages of these techniques are less discomfort to the patients, low rate of complications, short hospital stay.

Author Biographies

  • R.F. POPA, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

  • I. CAZAN, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

  • Genoveva BAROI, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

  • Simona CAZAN, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

  • G. LEFTER, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

  • Cristina STROBESCU, University of Medicine and Pharmacy “Grigore T. Popa” - Iaşi

    Faculty of Medicine
    Department of Surgery

References

1. Rutherford R. Vascular Surgery, Philadelphia: Elsevier, 2014, 902-913.
2. Laura Stătescu, et al. Chronic venous disease cases at the Iaşi dermatology clinic. Rev. Med. Chir 2014; 118: 1000-1007.
3. Cândea V. ChirurgieVasculară, Bolile venelor si limfaticelor, Bucureşti: EdituraTehnica, 2001, 163-170.
4. Sandri JL, et al. Diameter-reflux relationship in perforating veins of patients with varicose veins. J. Vasc. Surg 1999; 30: 867-874.
5. Jiang P, et al. Recurrent varicose veins: patterns of reflux and clinical severity. Cardiovasc. Surg 1999; 7: 332-339.
6. Rutherford EE, et al. Incompetent perforating veins are associated with recurrent varicose veins. Eur. J.Vasc. EndovascSurg 2001; 21: 458-460.
7. Gloviczki P, Bergan J, (editors). Atlas of endoscopic perforator vein surgery, London: Springer-Verlag, 1998.
8. Elias S, PendenE. Ultrasound-guided percutaneous ablationfor the treatment of perforating vein in-competence. Vascular 2007; 15: 281-289.
9. Guex JJ. Ultrasound guided sclerotherapy (USGS) for perforating veins. Hawaii Med. J 2000; 59: 261-262
10. De Palma Rg. Linton’s operation and modification of the open techniques. Am. J. Surg 1998; 137: 810-813.
11. Luebke T, et al. Meta-analysis of subfascial endoscopic perforator vein surgery (SEPS) for chronic venous insufficiency. Phlebol 2009; 24: 8-16.
12. Masuda EM, et al. The effect of ultrasound-guided sclerotherapy of incompetent perforator veins on venous clinical severity and disability scores. J. Vasc. Surg 2006; 43: 551-556.
13. Labropoulos N, Tassiopoulos AK, Bhatti AF, Leon L. Development of reflux in the perforator veins in limb with primary venous disease. J. Vasc. Surg2006; 43: 558-562.
14. Blomgren L, et al. Changes in superficial and perforating vein after varicose vein surgery. J. Vasc. Surg2005; 42: 315-320.

Additional Files

Published

2016-06-30