Miniincisional ligation of incompetent perforating veins of the legs.

Abstract

The purpose of this study was to determine the effectiveness of a new surgical procedure for interrupting incompetent perforating calf veins in patients with recalcitrant venous ulcers. Eighteen patients with venous ulcerations in 26 limbs had incompetent perforators diagnosed by duplex scanning. All were taken to the operating room, where the fascial defects through which the perforators coursed were obliterated by a "pursestring" permanent suture placed on the leg fascia. Follow-up duplex scanning was carried out within 2 weeks of the procedure and every 6 months thereafter. The mean follow-up in this series was 22 months. Initial success in obliterating the perforators was noted in 24 (92.3%) of 26 legs. Three subsequent failures occurred within 6 months for a midterm success rate of 80.7%. No wound complications or infections occurred. All ulcers healed within 6 weeks of the procedure (mean, 23 days) in the successfully treated patients. Miniincisional ligation of incompetent perforating veins is easy to perform and has very encouraging early results.