The Role of Superficial Venous Surgery in the Management of Venous Ulcers: A Systematic Review

Abstract

Evidence from the current literature, would suggest that superficial venous surgery is associated with similar rates of ulcer healing to compression alone, but with less recurrence. The effects of post-operative compression and DVI on the efficacy of surgery are still unclear.

Bordetella trematum in chronic ulcers: report on two cases and review of the literature

“…Wound debridement is an essential component of the management of infected ulcers. Debridement promotes healing, removes pathogens present in nonviable tissues, and reduces the recurrence of infection [18]. Our second case reported, demonstrates how the combination of both surgical debridement and effective antibiotic therapy shows a favorable outcome of B. trematum infection.…”

A randomized, investigator-blinded, controlled pilot study to evaluate the safety and efficacy of a poly-N-acetyl glucosamine–derived membrane material in patients with venous leg ulcers

“…22 Despite the common use of autologous skin grafting to treat difficult-to-heal ulcers, no randomized clinical trial of this treatment has demonstrated increased healing of VLUs or compared its wound-healing efficacy with other wound care strategies. 24 Although venous surgery with compression bandaging reduces ulcer recurrence, it does not improve healing, 25 and carries the usual risks of surgery and anesthesia; further, up to 35% of eligible patients refuse surgical intervention. 11 Given the benefits and risks associated with currently available treatments for difficult-to-heal VLUs, data from this pilot study suggest that pGlcNAc wound-healing technology is effective and results in no significant treatmentrelated adverse effects.…”

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

“…331,332 Several ablation techniques remain under investigation, including steam ablation and pharmacomechanical and cyanoacrylate ablation as well as CHIVA (ambulatory conservative hemodynamic management of varicose veins; one small RCT showed that CHIVA had a higher proportion of ulcers heal than with compression alone) and ASVAL (ambulatory selective varicose vein ablation under local anesthesia). 20,257,[333][334][335][336][337][338] The evidence supporting this guideline is an extrapolation of the data on ulcer healing and prevention of ulcer recurrence stated under Guidelines 6.1 and 6.2. In this group of patients, VLUs had healed, and so intervention is expected to provide protection from recurrence as noted in our commissioned comparative systematic review and meta-analysis and the two RCTs.…”