الفهرس | Only 14 pages are availabe for public view |
Abstract Summary & Conclusion This study was conducted in Vascular surgery outpatient clinic, Tanta University during period from June 2017 to November 2018. The study included 20 patients (19 males; 95% and one female 5%) with mean age 44.15 years presenting with active lower limb chronic venous leg ulcer C6 for time ranged between 4 months and 17 years that was under different methods of management without response. Every patient was carefully assessed through: full history taking, complete general, local examination and duplex scanning. The ulcer was on the left lower limb in 12 (60%) patients. Medial aspect of the leg was affected by 14 (70%) ulcers for a median duration of 3.25 years. Seven patients (35%) presented by recurrent ulcers. The included ulcers surface area ranged from 1.0 cm2 to 20.0 cm2 with a median of 6.75 cm2 All patients presented with active venous leg ulcer associated with edema only in 16 patients (80%) or pigmentation in 17 patients (85%) or lipodermatosclerosis in (75%). Eight patient (40%) presented with secondary chronic venous leg ulcer due to previous history of DVT. Pre procedure duplex revealed that 7 patients (35%) had isolated superficial venous incompetence, 2 patients (10%) with incompetent Summary & Conclusion 133 perforators only, 6 patients (30%) had incompetent deep venous system only and 4 patients presented with incompetent more than one system. The primary end points were ulcer healing rate and complete ulcer healing. While secondary endpoints were rate of ulcer recurrence within one year of follow up and the proportion of the procedure related complications. Evolution in management of venous leg ulcer was parallel to evolution in management of portal hypertension as management of portal hypertension transformed gradually from major surgical procedure like shunt operations, non shunt operations and splenectomy to new era of. |