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Introduction : The treatment for venous ulcers in most cases is unsatisfactory, with recurrences and poor healing.. Objective : To evaluate adjuvant therapy in the treatment of active venous ulcers.. Methods : We analyzed 20 patients with active venous ulcers attending the general Surgery out-patient clinic at the "Dr. They were randomly divided into 2 groups: group A 11 patients underwent compression therapy and group B 9 patients underwent compression therapy plus removal of the vein that gives terminal reflux to the ulcer, guided by ultrasound microphlebectomy.
Patients were evaluated weekly 8 weeks. At each assessment, photographs and lesion measurements were taken and pain was evaluated using the visual analog scale.. Conclusions : The results obtained in patients with surgical procedure group B are consistent with the reported efficacy of chronic venous ulcer treatment with saphenectomy conventional surgery , the difference is that in this study we used a minimally invasive procedure microphlebectomy..
A venous ulcer is the most serious consequence of chronic venous insufficiency. This disease has been known for over years. Nowadays, it is a pathology which draws little attention, despite new findings regarding its pathogenesis and treatment. In our opinion, we should focus on its healing rather than on the cause of the problem. Bonn Vein Study included participants, finding changes in pigmentation or eczema in 2.
Current theories about the etiology of severe chronic venous insufficiency are related to chronic venous hypertension. This suggests a role in cytokines, demonstrated by the presence of beta growth factor, which may cause fibrosis by stimulation of the extracellular matrix, reducing oxygen and nutrient circulation thus resulting in changes in the color and consistency of the skin.
Advanced isolated venous insufficiency includes a sensation of excessive weight on the legs as well as edema. Signs include a phlebostatic crown spider-shaped outbreak consisting of small varicose intradermal veins on the medial aspect of the ankle and foot , and changes in skin such as lipodermatosclerosis, which in its chronic phase develops as shiny, hardened and pigmented skin. Pulse palpation and the ankle-brachial index test are necessary in order to rule out an arterial insufficiency. Treatment includes general measures: patient education, weight loss, elevation of the extremity and exercise.