Leg ulcer. Conservative management or surgical treatment?
A. Kitahama, L. F. Elliott, M. D. Kerstein and C. V. Menendez
In a specific indigent socioeconomic setting, the nonsurgical management of
65 patients with chronic leg ulcers resulted in 59 cures. There were 42
patients (67%) with postphlebitic syndrome. Twenty-two patients (33%) had
varicose veins (eight had postoperative vein stripping), 14 (22%) had
deep-vein thrombosis, and 11 (15%) had associated neurological problems.
Fifty-six patients (86%) were treated with pressure dressings that were
changed once a week in an outpatient clinic, seven patients wore skintight
plaster casts for variable periods of time, and two patients had split
thickness skin grafts plus lumbar sympathectomies. In more than two thirds
of the patients, the ulcers healed. In another 17 patients (26%), a
satisfactory response to treatment was observed. In only six patients did
therapy fail. Failures were attributed to the multiple medical and surgical
problems of the patients or their lack of cooperation. Nonsurgical
treatment of venous stasis ulcer is inexpensive and effective.
