Surgery in addition to compression treatment could reduce the risk of recurrent leg ulcers

A UK study in this week's issue of THE LANCET highlights how surgery in addition to compression treatment could substantially reduce the risk of recurrent leg ulcers.

Venous leg ulceration affects 1-2% of people and accounts for 1% of health costs in developed countries. Treatment includes compression, leg raising, and exercise; no randomised trials have been done to investigate whether superficial surgery to remove part of the affected vein could be another treatment option.

Keith Poskitt from Cheltenham General Hospital, UK, and colleagues assessed the healing and recurrence rates after treatment with compression with or without surgery in people with leg ulceration. 500 patients were assessed by venous duplex imaging and were randomly allocated either compression treatment alone or in combination with superficial venous surgery.

The one-year recurrence rate was more than halved among Patients given surgery and compression compared with those given compression alone (12% compared with 28%, respectively). Healing rates were similar between the two groups.

Mr Poskitt comments: "Surgical correction of superficial venous reflux reduces 12-month ulcer recurrence. Most patients with chronic venous ulceration will benefit from the addition of simple venous surgery. This will result in reduced numbers of patients suffering with this chronic relapsing condition".

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