Outcome of combined surgery with compression therapy for management of venous leg ulcer

M. Rownak Khurshid; M. Ashraful Islam; Hossain Al Mahmud; Mohammad Tanvir Ahmed Chowdhury; Nushrat Sharmin Linda

doi:10.18203/2349-2902.isj20243535

Authors

M. Rownak Khurshid Department of Cardiovascular Surgery, Vascular Surgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh
M. Ashraful Islam Department Cardiovascular Surgery, Square Hospital, Dhaka, Bangladesh
Hossain Al Mahmud Department of Thoracic Surgery, Combined Military Hospital, Dhaka, Bangladesh
Mohammad Tanvir Ahmed Chowdhury Department of Surgery. Kurmitola General hospital, Dhaka, Bangladesh
Nushrat Sharmin Linda Dental Surgeon, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20243535

Keywords:

Compression therapy, Surgery, Venous leg ulcer

Abstract

Background: Venous leg ulcers (VLUs) are late indicators of chronic venous insufficiency (CVI) and venous hypertension. Compression therapy (CT) with multilayer bandage is the first line of treatment modality of ulcer management. But CT has a slow ulcer healing rate and high chance of recurrence. The present study was conducted to identify the outcome of combined surgery with compression therapy to manage VLU.

Methods: In this prospective study, 60 patients were included who presented to the department of cardiovascular surgery of Dhaka Medical College and Hospital between January 2021 to December 2023. The patients were divided into two groups. Group A included the patients who underwent surgery combined with compression therapy while Group B patients received only compression therapy (CT). Ulcer healing time, recurrence rate and Venous Clinical Scoring System (VCSS) were analysed to determine the outcome.

Results: There was no significant difference in the demographic variables between two groups. 30 limb ulcers healed in the combined treatment group with a median healing time of 1.6 months (95% CI, 1.42–1.82), while 24 limb ulcers healed in the CT alone group with a median healing time of 2.15 months (95% CI, 1.92–2.45). The ulcer healing time was shorter in the combined treatment group than in the CT alone group (HR for ulcer healing 1.98, 95% CI, 1.474–2.309, p<0.05). Recurrence rate was higher in CT group (16.66% vs 53.33%). Besides VCSS was lower in Combined group that CT group after 1month, 6 month and 12 month of follow-up which was statistically significant. (p<0.05)

Conclusions: The present study has demonstrated combined treatments can shorten the ulcer healing time and reduce the ulcer recurrence rate compared with CT alone for treating VLU. Further randomized large scale multicenter study is recommended to provide a better management to the patients.

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