Conservative versus surgical treatment of venous leg ulcers: 10-year follow up of a randomized, multicenter trial

W. B. van Gent*, F. S. Catarinella, Y. L. Lam, F. H. M. Nieman, I. M. Toonder, A. C. van der Ham, C. H. A. Wittens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Introduction Leg ulcers have a large socio-economic impact. Treatment modalities are either conservative or surgical. Conservative treatment involves local treatment and compression therapy. Surgical treatment of venous ulcers is based on correcting venous hypertension, by treating incompetent superficial, deep, and perforating veins. A prospective randomized multicenter trial comparing surgical treatment (combined superficial and perforating vein surgery) with ambulatory compression therapy was conducted during 1998 and 2001. This paper presents the results of a 10-year follow-up period of this trial. Materials and methods All patients enrolled in the original prospective trial were approached and invited for additional examination and duplex ultrasound evaluation. Secondary, disease specific and generic quality-of-life (QoL) was assessed. Current ulcer state and recurrence during the follow-up period was assessed. Results After a mean of 97 months follow up, 80 (41%) out of 196 legs could be inspected. The incidence of ulcer-free, the main outcome, was significantly (p=0.007) higher in the surgical group (58.9%), compared to the conservative group (39.6%). Observed ulcer recurrence was 48.9% for the surgical group and 94.3% for the conservative group. The number of incompetent perforating veins appears to be a significant (p
Original languageEnglish
Pages (from-to)35-41
JournalPhlebology: The Journal of Venous Disease
Publication statusPublished - Mar 2015


  • Subfascial endoscopic perforating vein surgery
  • perforating veins
  • venous incompetence
  • chronic venous insufficiency
  • deep venous insufficiency
  • venous ulcers
  • compression therapy
  • venous ulcer recurrence

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