Leg ulcer surgery

Today the repertoire of surgical treatment in the therapy of recalcitrant leg ulcers is sufficient. Varicose vein surgery and endovenous techniques are suited to eliminate primary or secondary varicose veins as a causal therapeutic approach. Shave therapy is the first choice in treatment of non-healing leg ulcers of different types. There are good long-term results with complete healing in 70-80%. Surgical procedures, including the fascia cruris (fasciotomy, fasciectomy), are reserved for special indications. Fasciectomy is mainly indicated for deep transfascial necrosis, failure of shave therapy and severe tissue ossifications. Recurrent ulcerations can be treated with a redo-layered shaving, optional with a simultaneous VAC therapy or with fasciectomy. Good longterm results are at first depending on a standardized postsurgical treatment. Specialized home nursing care is sometimes necessary, too.