Does the pattern of venous insufficiency influence healing of venous leg ulcers after skin transplantation?

Abstract

Aims: This study aimed to investigate the influence of venous insufficiency on results in venous leg ulcers treated with ulcer excision, meshed split-skin transplantation and correction of superficial venous insufficiency in the wound area. Design: Retrospective cohort study. Setting: Copenhagen Wound Healing Center. Methods: In 113 patients with venous leg ulceration, examined preoperatively with colour Duplex scanning (CDS), prognostic factors of healing and recurrence within 1 year were analysed using logistic regression. Results: Cumulative 1-year healing rate was 65% (73 patients) and 13 (12%) had recurrence of ulceration 1 year postoperatively. Initial ulcer size (OR: 0.97(95% CI: 0.96-0.99)), minor local superficial venous surgery (OR: 2.38 (95% CI: 1.04-5.46)), sufficient popliteal vein (2.97 (1.05-8.42)) and non-compliance with compression therapy (OR: 0.27 (95% CI: 0.11-0.71)) influenced the prognosis of healing positively. No statistically significant differences in healing and recurrence between patients with isolated superficial and mixed superficial/deep venous insufficiency was found. Conclusion: Non-healing venous leg ulcers can be treated with ulcer excision, meshed split-skin transplantation and correction of superficial venous insufficiency in the wound area with beneficial results irrespective of underlying pattern of venous insufficiency as determined by CDS.