Healing Evaluation of Varicose Leg Ulcers after Injection Sclerotherapy of Pathological Leg Perforator Veins

Abstract Background Scottish Guideline defined the chronic venous leg ulcer “as an open lesion between the knee and the ankle joint that remains unhealed for at least four weeks and occurs in the presence of venous disease”. Venous Leg Ulcers (VLUs) account for 70% of all leg ulcers and estimates 1% of the population with a prevalence that increases with age according Edinburgh study, which was a cross-sectional study of a random sample. Aim of the Work To evaluate the efficacy of injection sclerotherapy of incompetent perforators in the healing of venous leg ulcers. Patients and Methods This study was conducted on 50 patients with chronic venous leg ulcers that had been presented for at least four weeks ago. To evaluate the clinical efficacy of Duplex-guided foam sclerotherapy with compression therapy in comparison with compression therapy alone, we divided the patients with randomization into two groups. Group A was conservatively managed by four-layer compression bandage and Group B was managed by application of duplex guided injection sclerotherapy and four-layer compression bandage. Results In our study, there is statistically significant positive correlation between duration of ulcer, ulcer surface area and duration to complete healing. On linear regression analysis of factors significantly correlated with duration of complete healing, only ulcer surface area at start of treatment was significantly associated with it (β = 1.031, p < 0.001). Increased ulcer surface area at start of treatment by 1 cm2 increases duration of healing by about 1 week. Conclusion Duplex-guided sclerotherapy is a simple procedure, no hospitalization, no anaesthesia, can be done in outpatient clinic and the patient can return home after 45 min and no work off period. The relative healing period and its evident success, make this the first line treatment for venous ulcer and superior to compression alone.