Rápida cicatrización de la úlcera venosa con técnica TAPIRS-LF con láser, espuma y vendajes multicapa

Abstract

IntroductionThe traditional surgical techniques are being replaced by minimally invasive procedures, such as Endovenous Laser (Thermal, Tumescent), and ultrasound foam sclerotherapy (Non-Thermal, Non-Tumescent). The aim of this study was to determine the healing time and rate of venous ulcers (VU) using a Terminal, Axial and Perforator Interruption of the Reflux Source (TAPIRS-LF) protocol. This included Endovascular Laser Treatment and endoluminal venous occlusion with ultrasound-guided foam and a multilayer bandage system until ulcer healing was achieved. Material and methodsA prospective non-controlled trial was conducted on patients with chronic venous leg ulcers (CEAP [clinical, etiological, anatomical and pathological elements] classification C6) during 2015 and 2016. A total of 27 patients aged 18 years and over, presenting with venous insufficiency, VU, and an ankle-brachial index greater than 0.8, were included, with a total of 27 extremities being analysed. All of the patients were subjected to thermal and non-thermal endoluminal occlusion, with endovenous laser treatment in axial venous system, with ultrasound-guided foam in the distal axial superficial venous system and perforator and terminal veins near to the ulcer, using the Tessari method with 3% polidocanol. Follow-up was carried out every week and a Doppler test was performed after 4, 12, and 24 weeks. ResultsThe mean age of the patients was 59.6 years. The active ulcer duration prior to treatment was 11.7 months. The mean VU diameter was 15.06 cm2, and 92.5% VU were seen to be healing at 8 weeks. ConclusionsThe minimally invasive ablation using Terminal, Axial and Perforator Reflux with compression in patients with active VU results in a faster healing during the treatment of chronic venous ulcers.