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下肢静脉溃疡患者的溃疡下泡沫硬化疗法:134例连续患者的分析与技术要点

Sub-ulcer Foam Sclerotherapy in Patients with Venous Leg Ulcer, Analysis and Technical Aspects of 134 Consecutive Patients.

作者信息

Pihlaja Toni, Kosunen Emmi, Ohtonen Pasi, Pokela Matti

机构信息

Department of Vascular Surgery, Oulu University Hospital, Oulu, Finland.

Medical Research Center Oulu, University of Oulu, Oulu, Finland.

出版信息

Int J Low Extrem Wounds. 2024 Apr 4:15347346241245765. doi: 10.1177/15347346241245765.

Abstract

OBJECTIVE

For this retrospective study, we analyzed the sub-ulcer foam sclerotherapy technique in patients with venous leg ulcer (VLU).

METHODS

This study included 134 patients treated with sub-ulcer foam sclerotherapy at the Oulu University Hospital vascular outpatient clinic from January 2012 to December 2021. All included patients received sub-ulcer foam sclerotherapy as part of the treatment strategy for superficial venous insufficiency. Compression therapy and local wound care were organized for VLU treatment. A follow-up visit was scheduled for one month after the sub-ulcer foam sclerotherapy. Change in ulcer size, local (skin necrosis, infection) or systemic (deep vein thrombosis, pulmonary embolism) complications, and time to ulcer healing were monitored. The occurrence of major limb-related complications (amputation, surgical revision) was monitored for one year postoperatively.

RESULTS

One month after sub-ulcer treatment, ulcers were smaller or completely healed in 108 (81%) patients. Ulcer healing was completed in 123 (92%) patients at one year and 131 (98%) patients at two years. Complications were recorded in four (3%) patients, three (2%) who were diagnosed with erysipelas requiring antibiotic treatment and one (1%) patient diagnosed with local dermatitis. During the one-year follow-up, no major limb-related complications (surgical revisions or amputations) arose.

CONCLUSIONS

Sub-ulcer foam sclerotherapy may be a feasible addition to superficial vein reflux elimination in patients with VLU and a low risk for complications.

摘要

目的

在这项回顾性研究中,我们分析了下肢静脉溃疡(VLU)患者的溃疡下泡沫硬化疗法技术。

方法

本研究纳入了2012年1月至2021年12月在奥卢大学医院血管门诊接受溃疡下泡沫硬化疗法治疗的134例患者。所有纳入患者均接受溃疡下泡沫硬化疗法,作为浅静脉功能不全治疗策略的一部分。为VLU治疗组织了加压治疗和局部伤口护理。在溃疡下泡沫硬化疗法后1个月安排随访。监测溃疡大小的变化、局部(皮肤坏死、感染)或全身(深静脉血栓形成、肺栓塞)并发症以及溃疡愈合时间。术后1年监测主要肢体相关并发症(截肢、手术翻修)的发生情况。

结果

溃疡下治疗1个月后,108例(81%)患者的溃疡变小或完全愈合。123例(92%)患者在1年时溃疡愈合,131例(98%)患者在2年时溃疡愈合。4例(3%)患者出现并发症,3例(2%)被诊断为丹毒需要抗生素治疗,1例(1%)患者被诊断为局部皮炎。在1年的随访期间,未出现主要肢体相关并发症(手术翻修或截肢)。

结论

溃疡下泡沫硬化疗法可能是VLU患者消除浅静脉反流的一种可行补充方法,且并发症风险较低。

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