Crossectomy and Foam Sclerotherapy of the Great Saphenous Vein versus Stripping of Great Saphenous Vein and Varicectomy in the Treatment of the Legs Ulcers
Objective. To show our results in the surgical treatment of legs varicose ulcers, with crossectomy and foam sclerotherapy (CAFE) of the great saphenous vein (GSV) in group I and stripping of GSV and varicectomy in group II. Methods. 35 patients with active venous leg ulcers were recruited and treated. They were collected in two groups. Group I were treated by crossectomy and foam sclerotherapy of the GSV and group II were treated by stripping of GSV and varicectomy. The healing time of the ulcer and the complications were recorded after the procedure in the follow-up visits. Results. 29 out of the 35 patients completed the follow-up. There were eight cases of incomplete healing of the leg ulcer, 4 in group I (19.04%) and 4 in group II (40%), . The average rate of healing in group I was 0.38？cm/day and 0.13 in group II, . Conclusion. CAFE technique of the great saphenous vein in the treatment of 6 CEAP patients is a procedure that improves the rate of ulcer healing as compared to these two groups. It is a safe and reliable minimally invasive method, with less morbidity. 1. Introduction Venous ulcers are the last state of the chronic venous insufficiency which treatment is long, expensive, and disappointing. The affected patients are usually treated by compressive therapy of the legs and wound dressings of different kinds [1]. The association of venous ulcers and saphenous vein reflux is well established, and therefore we encourage a rapid surgical decision on these patients focused on the hemodynamic control rather than the treatment of the ulcer alone [2, 3]. Ablative procedures of the superficial venous system with complete resection of the saphenous veins and varix imply the risk of complications such as contamination and infection of the surgical wounds. Reliability of this technique and the recent reintroduction of sclerosing agents with higher foam stability allow the possibility to occlude saphenous trunks with minimal invasiveness and in a very practical way [4]. We report our early experience with crossectomy and foam sclerotherapy (CAFE) of the great saphenous vein in patients with saphenous vein reflux and venous ulceration. 2. Materials and Methods 2.1. Patients and Groups Between September 2008 and January 2010, 35 patients with active venous leg ulcer were recruited for the study. Twenty-nine accomplished the follow-up period. Group I consisted of 21 patients (23 limbs), 6 males, and 15 females, with an average age of 58.9 years (range: 36–86). Of the 21 patients, 17 had primary CVI and 4 had postthrombotic limbs. Group II had 8 patients
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