Leg ulcers abate with surgery.
The investigators randomly assigned 500 patients to undergo either surgery plus multilayer compression bandaging or compression treatment alone. Most patients (60%) had isolated superficial venous reflux; 25% had mixed superficial and segmental deep venous reflux, and 15% had mixed superficial and total deep venous reflux, the investigators said (Lancet 363:1854-59, 2004).
Ulcer healing was similar between groups at 24 weeks, so the surgery did not enhance initial outcomes. However, recurrence rates 1 year later were much lower in the surgically treated group (12%) than in the compression-only group (28%). Surgery conferred this advantage in all patients, regardless of the type of venous reflux they had or the presence of comorbidities, such as diabetes.
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|Title Annotation:||Clinical Capsules|
|Author:||Moon, Mary Ann|
|Publication:||Internal Medicine News|
|Article Type:||Brief Article|
|Date:||Jul 1, 2004|
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