Duplex Guided Injection Foam Sclerotherapy for Incompetent Perforators Combined with Skin Grafting in Venous Leg Ulcer.

Document Type : Original Article

Authors

1 Vascular Surgery Department, Faculty of Medicine, Helwan University, Egypt

2 General Surgery Department, Faculty of Medicine, Helwan University, Egypt

3 Plastic Surgery Department, Faculty of Medicine, Helwan University, Egypt

10.21608/asjs.2024.368114

Abstract

of chronic venous insufficiency.
Aim of work: To evaluate the clinical efficacy of duplex-guided foam sclerotherapy combined with skin graft.
Patients and methods: This prospective follow-up (cohort) study was conducted on 20 patients with venous
leg ulcers and incompetent perforator veins who were referred to the Vascular and Plastic Surgery Department at
Helwan University Hospitals.
Results: The mean percentage of healing in the ulcer surface area post-injection was 82.5% after 1 week; this
was reduced to 79.5% and 81.5% after 2 and 4 weeks, respectively. The total mean size of the ulcer was 5.60 ±
14.73 cm². These changes in the size of the ulcer were significantly different (p<0.001). At the last follow-up visit,
17 patients (85%) were still ulcer-free, while three ulcers (15%) recurred. After 6 months, all perforator veins were
ablated in 90% of patients, while multiple perforators showed reflux in two (10%) patients. Half of the patients
encountered complications.
Conclusion: Duplex-guided sclerotherapy with skin grafting is a simple procedure without suffering from
compression therapy or daily dressing. Also, the patient can return home after 1 day with the ability to do daily
work, and the sick leave period is a maximum 1 week. So, the evident success of this procedure and its relative
freedom from serious complications make it one of the most important lines of treatment for venous ulcers,
especially large ulcers.

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