Minimally invasive surgical management of primary venous ulcers vs. compression treatment: a randomized clinical trial

Objectives: to compare minimally invasive surgical haemodynamic correction of reflux (CHIVA) with compression in the treatment of venous ulceration. Design: prospective randomised study. Materials and methods: from a cohort of 80 patients with 87 venous leg ulcers, 47 were randomised to either surgery or compression. Results: at a mean follow-up of 3 years, healing was 100% (31 days) in the surgical and 96% (63 days), in the compression group (p < 0.02). The recurrence rate was 9% in the surgical and 38% in the compression group (p < 0.05). In the surgical group, all plethysmographic parameters except ejection fraction, had improved significantly at 6 months in the surgical group, and at 3 years residual volume fraction remained in the normal range. Finally, quality of life significantly improved in the operated group. Conclusions: this study supports the effectiveness of surgical therapy for leg ulceration secondary to superficial venous reflux.