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Document Type

Original Article

Abstract

Background: Varicose veins are twisted, swollen veins that typically affect the blood vessels in the lower extremities. Obesity and prolonged standing are the main causes of varicose vein disease. Inelastic bandages used in compression therapy are very successful to help venous leg ulcer healing. Stripping, which includes physically removing the vein, foam sclerotherapy, and thermal ablation with laser or radiofrequency are the most widely used methods for treating inefficient saphenous veins. Radiofrequency ablation (RFA), Sclerotherapy and phlebectomy are frequently combined with other operations and used to treat isolated tributary or perforator incompetence and recurrent varicose veins. Aim: To identifying the impact and influence of those different modalities on the incidence of healing of long-standing chronic venous leg ulceration, and the need for post procedure elastic stockings to facilitate the ulcer healing or not. Subject and Methods: This was a prospective randomized controlled trial that was conducted on 60 patients with varicose veins complicated by chronic venous ulcers. The study performed in the Department of Vascular Surgery, Al-Azhar University Hospitals. Patients were divided into 2 equal groups:-

Group (1): included 30 patients and treated by great saphenous vein stripping and complete clearance of the sapheno-femoral junction (SFJ), in addition to stab avulsion technique for below knee varicosities.

Group (2): included also 30 patients and treated with radiofrequency (RF) ablation technique.

Results: Regarding Venous Disability Score classification (VDS) distribution between the two studied groups, there is no significant difference between the two groups regarding classification.

Regarding postoperative visual analog scale (VAS), analgesic duration, return to normal activity, and return to work, there is a considerable difference between the two groups. The degree of ecchymosis varies significantly between the two groups. Postoperative venous clinical severity score (VCSS) in the RF group was considerably lower than in the surgical group. Conclusion: The current experiment demonstrated the excellent efficacy of both surgery and RFA. Both led to improvement in the objective severity of venous illness and a notable reduction in the size of venous ulcers.

Keywords

Varicose veins, Venous Ulcers, Surgery

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