J Korean Soc Plast Reconstr Surg.  2009 May;36(3):336-340.

A Case of Venous Stasis Ulcer Treated by Subfascial Endoscopic Perforator Ligation and Split Thickness Skin Graft

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University, Seoul, Korea. jwlpsdoc@yahoo.co.kr

Abstract

PURPOSE: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg.
METHODS
A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations-the split thickness skin graft-at different clinics, the wound did not heal. The size of the wound was 12 by 8 cm2 and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC(r) for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft.
RESULTS
Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications.
CONCLUSION
Subfascial endoscopic perforator ligation is a relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be a valuable method for treating severe venous stasis ulcers.

Keyword

Subfascial endoscopic surgery; Perforator veins; Venous stasis ulcers

MeSH Terms

Burns
Debridement
Edema
Fibrosis
Follow-Up Studies
Humans
Leg
Ligation
Male
Porphyrins
Postoperative Complications
Recurrence
Skin
Transplants
Varicose Ulcer
Veins
Venous Insufficiency
Porphyrins
Full Text Links
  • JKSPRS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr