Schmeller W, Gaber Y, Gehl H B
Department of Dermatology and Venereology, Medical University of Luebeck, Germany.
J Am Acad Dermatol. 1998 Aug;39(2 Pt 1):232-8. doi: 10.1016/s0190-9622(98)70081-7.
Leg ulcers in deep venous insufficiency, especially the postthrombotic type, are often resistant to therapy.
The purpose of this study was to evaluate short-term and long-term effects of shave therapy in persistent or recurrent venous ulcers.
From January 1994 to October 1997, 80 patients with 105 chronic leg ulcers were treated by shave therapy. This method involved removing ulcers together with the surrounding lipodermatosclerosis and covering the wounds with meshed split-skin graft. Fifty-nine patients with 76 ulcers were examined after 3 months for assessment of short-term results. The first 18 patients with 26 ulcers from the years 1994 and 1995 were evaluated for long-term results.
The short-term healing rate after 3 months in 59 patients was 79%. Of 8 patients from 1995 (follow-up period, 1 year and 8 months), 7 patients had complete healing and 1 patient had a small ulcer. Of 10 patients from 1994 (average follow-up period, 2 years and 8 months), 8 patients had complete healing and 2 patients showed small superficial ulcerations within the transplanted areas. From these results, a long-term healing rate of 88% was calculated in 18 patients. Two of the 3 patients with recurrences had stopped compression therapy after good short-term results.
For patients with recalcitrant leg ulcers in deep venous insufficiency and/or postthrombosis, shave therapy is a simple, quick, and effective surgical method with favorable short-term and long-term results.
下肢深静脉功能不全引起的腿部溃疡,尤其是血栓形成后型溃疡,往往对治疗有抵抗性。
本研究旨在评估削痂疗法对持续性或复发性静脉溃疡的短期和长期疗效。
1994年1月至1997年10月,80例患者的105处慢性腿部溃疡接受了削痂疗法。该方法包括切除溃疡及其周围的脂性皮肤硬化组织,并用网状断层皮片覆盖创面。59例患者的76处溃疡在3个月后接受检查以评估短期疗效。对1994年和1995年的首批18例患者的26处溃疡评估长期疗效。
59例患者3个月后的短期愈合率为79%。1995年的8例患者(随访期为1年8个月)中,7例完全愈合,1例有小溃疡。1994年的10例患者(平均随访期为2年8个月)中,8例完全愈合,2例在移植区域内有小的浅表溃疡。根据这些结果,18例患者的长期愈合率为88%。3例复发患者中有2例在短期疗效良好后停止了压迫治疗。
对于下肢深静脉功能不全和/或血栓形成后顽固性腿部溃疡患者,削痂疗法是一种简单、快速且有效的手术方法,短期和长期疗效良好。