Angiology Department, Clinica MD Barbantini, Via del Calcio 2, 5510 Lucca, Italy.
Clin Plast Surg. 2012 Jul;39(3):269-80. doi: 10.1016/j.cps.2012.04.004.
This article reviews published data on the effects of surgery and compression in the treatment of venous ulcers and the best options for compression therapy. Randomized controlled studies reveal that surgery and compression have similar effectiveness in healing ulcers but surgery is more effective in preventing recurrence. Most leg ulcers have a venous pathophysiology and occur because of venous ambulatory hypertension caused by venous reflux and impairment of the venous pumping function. Proposed surgical interventions range from crossectomy and stripping to perforator vein interruption and endovascular procedures (laser, radiofrequency). More conservative procedures (foam sclerotherapy, conservative hemodynamic treatment) have also been proposed.
本文综述了已发表的关于手术和加压治疗静脉溃疡的效果以及最佳加压治疗选择的数据。随机对照研究表明，手术和加压在溃疡愈合方面具有相似的效果，但手术在预防复发方面更有效。大多数腿部溃疡具有静脉病理生理学特征，是由于静脉反流和静脉泵功能障碍引起的静脉活动期高血压所致。提出的手术干预措施包括交叉切除术和剥离术、穿通静脉阻断术和血管内手术（激光、射频）。也提出了一些更保守的方法（泡沫硬化疗法、保守血流动力学治疗）。
