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Management of Venous Ulceration: Excision, Skin Grafting and Microsurgical Flaps

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Chronic Venous Insufficiency

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Abstract

A regimen of leg elevation, compression bandaging and local wound care is successful in healing the majority of venous ulcers. Failure of a venous ulcer to heal with appropriate wound care or recurrence despite these measures leaves the physician with a challenge in which multiple factors must be addressed in order to achieve long-term wound closure. Most surgical interventions employed to address refractory venous ulceration have been directed at correcting underlying venous hypertension with the assumption that this would lead to resolution of the ulcer. However, even if successful control of venous hypertension in the extremity is achieved, a chronically scarred wound with compromised healing capacity may remain and require surgical reconstruction. Thus, the approach to reconstruction of the tissue defect associated with chronic venous ulceration is the subject of this chapter.

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  1. Raymond M. Dunn
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  2. Michael J. Rohrer
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  3. Adam J. Vernadakis
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Editors and Affiliations

  1. Division of Vascular Surgery, Loma Linda University Medical Center, 11175 Campus St, RM#21123, Loma Linda, California, CA, 92354, USA

    Jeffrey L. Ballard MD, FACS

  2. North Coast Surgeons, 9850 Genessee Avenue, Suite 560, La Jolla, California, CA, 92037, USA

    John J. Bergan MD FACS

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Dunn, R.M., Rohrer, M.J., Vernadakis, A.J. (2000). Management of Venous Ulceration: Excision, Skin Grafting and Microsurgical Flaps. In: Ballard, J.L., Bergan, J.J. (eds) Chronic Venous Insufficiency. Springer, London. https://doi.org/10.1007/978-1-4471-0473-5_13

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  • DOI: https://doi.org/10.1007/978-1-4471-0473-5_13

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