Venous ulcers in chronic venous insufficiency: King Khalid University Hospital experience

Background. The purpose of this study was to identify the anatomical location of the venous disease in C.V.I. patients presented with venous ulcers in addition to discussing the management, Design. Retrospective study, at King Khalid University Hospital. Methods. Between January 1991 to January 1991, 90 patients (63 females, 21 males) with CVI were evaluated. The evaluation included history, clinical examination, bidirectional ultrasound continuous wave Doppler, Duplex, ambulatory venous pressure (AVP), ascending and descending venography. Results. Forty eight (48) patients (57 limbs) had Stage III with venous ulcers. Out of these 48 patients, fifteen (15) showed deep venous system involvement with deep vein thrombosis (DVT). Thirty three (33) patients had venous reflux in the superficial or deep systems without occlusion. Out of these 33 patients, 24 patients had superficial system reflux, while the remaining 9 patients revealed deep system reflux with a competent superficial system. Conclusions. Superficial venous incompetence plays a major role in venous ulcer formation and that location and type of venous disease should be thoroughly investigated as surgical excision of the superficial system leads to a long standing recurrence free period.