Long-Term Outcomes of Flap Transfer for Treatment of Intractable Venous Stasis Ulcers in the Lower Extremity

Abstract

There is little information about long-term outcomes of flap transfer for treatment of venous stasis ulcers in the lower extremity. Eleven patients who underwent free and pedicled flap transfer for treatment of intractable venous stasis ulcers were evaluated retrospectively. The operative procedures consisted of removal of the ulcer and surrounding lipodermatosclerotic tissue, venous stripping, and flap transfer. No ulcer recurrences in the territory of the transferred flap were identified for a mean of 11 years during the follow-up period. However, four patients developed new ulcers in the same leg after the flap transfer at 18, 24, 52, and 81 months. This was probably the result of incomplete excision of surrounding lipodermatosclerotic tissue. Three of four recurrent ulcers were healed with additional procedures. The results of this study indicated that flap transfer combined with venous stripping could lead to long-term healing of venous stasis ulcers. However, incomplete excision of surrounding lipodermatosclerotic tissue caused new ulceration around the transferred flap.