Venous Ulcer Surgery
What is Venous Ulcer Surgery ?
.
Why do you need Venous Ulcer Surgery ?
Venous ulcer surgery is indicated for:
- Venous ulcers:
- Chronic, non-healing ulcers due to venous insufficiency (e.g., great saphenous vein reflux, post-DVT obstruction).
- Symptoms: Open sores (often medial ankle), pain, swelling, skin changes (lipodermatosclerosis).
- Prevalence in India: 1–2% of adults over 60; higher in women, diabetics, and post-DVT patients (20–30% of DVT cases, as in your thrombectomy query).
- Other indications:
- Failed conservative treatment: Compression therapy, wound care (e.g., 3–6 months without healing).
- Recurrent ulcers: 50–70% recurrence rate without addressing venous pathology.
- Types:
- Endovenous ablation: EVLT or radiofrequency ablation (RFA) for superficial vein reflux (60–70% of cases; EVLT covered in your prior query).
- Vein stripping/ligation: Open surgery for severe reflux (10–15%).
- Deep vein surgery: Valvuloplasty or stenting for post-thrombotic syndrome (PTS, 5–10%).
- Skin grafting: For large, non-healing ulcers (5–10%).
- Associated treatments:
- Pre-op: Compression therapy, antibiotics if infected, debridement of ulcer.
- Post-op: Compression stockings (30–40 mmHg), wound dressings, skin care.
- Timing:
- Performed in adults (average age 50–70 years); elective after conservative measures fail; urgent if infection uncontrolled.
The procedure aims to heal the ulcer, reduce recurrence, and improve quality of life, with success rates depending on the underlying venous issue and patient compliance.
Why Do Costs Vary in Philippines?
.
Venous Ulcer Surgery Procedure
- Before Procedure Evaluation:
- Assessment:
- Duplex ultrasound: Maps venous anatomy, confirms reflux (e.g., >0.5 seconds in great saphenous vein) or obstruction (e.g., iliac vein).
- Wound culture: If infected (e.g., Staphylococcus aureus, common in 50–70% of cases).
- Blood tests: Blood sugar (diabetes control), albumin (nutritional status), clotting profile.
- Preparation: Antibiotics (if infected), continue compression; fasting 4–6 hours (if surgery under anesthesia).
- Consent: Risks, including recurrence, are explained.
- Assessment:
- Procedure Technique:
- Endovenous Laser Therapy (EVLT):
- As covered previously: Local anesthesia, 30–60 minutes; laser seals refluxing vein (e.g., great saphenous); outpatient.
- Deep Vein Stenting (PTS):
- Performed under local anesthesia with sedation, lasting 1–2 hours.
- Process:
- Access: Catheter via femoral vein (groin).
- Venogram: Confirms obstruction (e.g., iliac vein stenosis).
- Stent placement: Self-expanding stent (e.g., Wallstent) deployed to open vein.
- Closure: Access site sealed (manual pressure or closure device).
- Skin Grafting (Large Ulcers):
- Performed under general or local anesthesia, lasting 1–2 hours.
- Process:
- Debridement: Ulcer cleaned, dead tissue removed.
- Graft: Split-thickness skin graft harvested (e.g., thigh, 0.3–0.4 mm thick); applied to ulcer.
- Closure: Graft secured with sutures/staples; donor site dressed; compression applied.
- Intraoperative Tools:
- Ultrasound: Guides EVLT or stenting.
- Dermatome: Harvests skin graft.
- Compression: Applied post-procedure.
- Endovenous Laser Therapy (EVLT):
- After Procedure:
- Hospital stay: Same-day discharge (EVLT/stenting); 2–5 days (skin grafting).
- Care: Compression stockings for 4–6 weeks; wound dressings (e.g., hydrocolloid); elevate leg to reduce swelling.
- Pain management: Mild (EVLT) to moderate (grafting) pain for 1–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid prolonged standing for 2–4 weeks; keep dressings dry; monitor for infection.
Recovery After Venous Ulcer Surgery
- Hospital Stay: Same-day discharge (EVLT/stenting); 2–5 days (skin grafting).
- Post-Procedure Care:
- Pain: Mild (EVLT) for 1–3 days; moderate (grafting) for 3–5 days; resolves in 1–2 weeks.
- Activity: Walk immediately (EVLT); light activities in 2–3 days (grafting); avoid strenuous activity for 2–4 weeks.
- Compression: Wear stockings for 4–6 weeks (or lifelong in severe cases); reduces swelling.
- Ulcer healing: 70–90% heal within 3–6 months; skin graft integration in 2–4 weeks.
- Symptoms: Swelling, pain improve in 2–4 weeks; 80–90% report relief.
- Follow-Up:
- Visits at 1 week (check wounds), 1 month, and every 3–6 months (monitor recurrence).
- Ultrasound: At 1–3 months; 90–95% vein closure (EVLT) or stent patency at 1 year.
Most resume normal activities in 1–2 weeks (EVLT) or 2–4 weeks (grafting); full ulcer healing takes 3–6 months. Success rate: 70–90% ulcer healing; 30–50% recurrence at 5 years without lifelong compression.
Risks and Complications
- Procedure Risks:
- Bleeding (1–3%): At access site or graft donor site; resolves with pressure.
- Infection (5–10%): Higher risk in ulcers; treated with antibiotics.
- Graft failure (5–10%): Skin graft rejection; may need repeat grafting.
- Post-Procedure:
- Deep vein thrombosis (DVT, 1–2%): Minimized by walking, stockings (links to your thrombectomy query).
- Recurrence (30–50% at 5 years): Ulcer returns if venous insufficiency untreated or non-compliance with compression.
- Scarring (5–10%): Donor site (grafting); fades in 6–12 months.
- Numbness (1–3%): Temporary nerve irritation; resolves in 1–3 months.
- Long-Term:
- Chronic edema (10–20%): If underlying pathology persists; managed with compression.
- Cellulitis (5–10%): Recurrent infections; needs antibiotics, skin care.
Report fever, increased swelling, redness, or foul ulcer odor promptly.
Frequently Asked Questions (FAQs)
What causes the need for venous ulcer surgery?
Venous insufficiency (e.g., reflux, post-DVT obstruction) causing chronic ulcers, often after failed conservative treatment.
Can I avoid venous ulcer surgery?
Yes, if early-stage: Compression therapy, wound care (50–70% heal); surgery needed for non-healing or recurrent ulcers.
Is venous ulcer surgery painful?
Mild (EVLT) to moderate (grafting) pain for 1–5 days; managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: Immediately (EVLT) or 2–3 days (grafting); full recovery: 2–4 weeks; avoid strenuous activity for 2–4 weeks.
Is venous ulcer surgery covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, increased swelling, redness, or foul ulcer odor.
How effective is venous ulcer surgery?
70–90% ulcer healing within 3–6 months; 30–50% recurrence at 5 years without compression.
Lifestyle changes post-surgery?
Wear compression stockings, elevate legs, maintain skin hygiene, avoid prolonged standing, and attend follow-ups.
Conclusion
.
Looking for Best Hospitals for Venous Ulcer Surgery
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
|---|---|---|
|
Angeles City |
|
|
|
Antipolo |
|
|
|
Bacolod |
|
|
|
Bacoor |
|
|
|
Baguio |
|
|
|
Butuan |
|
|
|
Cagayan de Oro |
|
|
|
Caloocan |
|
|
|
Cebu City |
|
|
|
Dasmariñas |
|
|
|
Davao City |
|
|
|
General Santos |
|
|
|
General Trias |
|
|
|
Iligan |
|
|
|
Iloilo City |
|
|
|
Las Piñas |
|
|
|
Makati |
|
|
|
Malolos |
|
|
|
Manila |
|
|
|
Muntinlupa |
|
|
|
Parañaque |
|
|
|
Pasay |
|
|
|
Pasig |
|
|
|
Puerto Princesa |
|
|
|
Quezon City |
|
|
|
San Fernando |
|
|
|
San Jose del Monte |
|
|
|
Taguig |
|
|
|
Valenzuela |
|
|
|
Zamboanga City |
|
|
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.