Evaluation of the posterior approach for subfascial ligation of perforating veins.

A posterior midline incision was used for subfascial ligation of incompetent medial and lateral perforating veins in 32 patients. The indications for surgery were recurrent ulceration in 31 limbs and stasis dermatitis in six limbs. Incompetent perforating veins were found on the medial aspect of the leg in all cases and lateral aspect of the leg in 69% of cases. Postoperative mild skin edge necrosis and wound infection each occurred in seven limbs. Follow-up of these patients from 5 months to 4 years showed that there were 11 recurrent ulceration, 10 mild leg oedema and three recurrent varices. This operation was successful in preventing further leg ulceration in 70% of patients, and a further 21.6% had benefited from the operation in that ulcers which recurred in the follow-up period were small in size compared to the original ones, and healed quickly.