Surgical removal of ulcer and lipodermatosclerosis followed by split-skin grafting (shave therapy) yields good long-term results in "non-healing" venous leg ulcers

The purpose of this study was to evaluate the long-term effects of shave th erapy in non-healing venous leg ulcers. Forty-one patients with 75 recalcit rant leg ulcers caused by primary deep vein incompetence or post-thrombotic syndrome were operated by shave therapy (removal of ulcer and surrounding lipodermatosclerosis with a Schink skin-grafting knife and covering of the wounds with meshed split-thickness skin grafts). After an average follow-up period of 2 years and 5 months all patients were evaluated for long-term r esults. The healing rate of ulcers classified as non-healing was 67% (50 of 75 ulcers). The healing rate was 76% for ulcers associated with primary de ep vein incompetence and 58% for ulcers associated with postthrombotic synd rome (p=0.08). Even in cases with recurrence (33%) these ulcers were striki ngly reduced by 80-90% of their original size. Hypaesthesia was noticed in 38% of the transplanted areas. In "non-healing" venous leg ulcers due to de ep venous insufficiency shave therapy yields favourable longterm results. B ecause it is only a symptomatic treatment which does not reduce the patholo gical refluxes, continuous compression of the lower leg is important.