CLINICAL EVALUATION OF OPERATIVE TREATMENT FOR INCURABLE VENOUS ULCER FOLLOWING PRIMARY VARICOSE VEINS

During a period of 1969-88, 30 patients (14 males and 16-females) with primary varicose veins suffered from incurable leg ulcer were operated on in our institution. The average duration lasting lower extremity symptoms was 9.8 years in males or 10 years in females. While the average duration suffered from incurable leg ulcer was 14.6 months in males or 5.5 months in females. Solitary leg ulcers were seen in 23 cases and multiple ulcers in 7. Small ulcers measuring less than 2cm in diameter were completely cured by extensive whole saphenous vein stripping and excision of varices. For larger ulcers extrafascial or subfascial ligation of perforator branches with valve incompetence were performed. Furthermore, middle layer skin grafting was necessary for extensive ulcers measuring more than 3cm in diameter. Among 30 patients 9 needed skin grafting, and we have no experience of recurrence of treated ulcers. Thus incurable leg ulcer could be healed completely by operation within the average of 2.3 months.