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Biomedical subjects

M Scriven

Publications and source records attributed to M Scriven.

7 recordsLinked to original sources
PubMed1999

Role of superficial venous surgery in the treatment of venous ulceration.

BACKGROUND: The aim of this study was to determine the ability of superficial venous surgery to heal venous ulcers in lower legs with isolated superficial venous incompetence. METHODS: This was a prospective study of patients recruited from a venous ulcer assessment clinic. Ulcers were considered venous if the ankle : brachial pressure index was greater than 0.8 and duplex imaging showed venous reflux. Patients with isolated superficial venous incompetence were offered saphenofemoral and/or saphenopopliteal surgery. Neither perforator surgery, skin grafting nor postoperative compression hosiery or bandaging was used. RESULTS: A total of 122 legs with normal deep veins underwent superficial venous surgery. Ninety procedures (74 per cent) were done under local and 32 (26 per cent) under general anaesthesia. Sixty operations (49 per cent) were done as a day case. The median time to healing was 18 (95 per cent confidence interval 14-21) weeks and the cumulative 6-, 12- and 18-month healing rates were 57, 74 and 82 per cent respectively. CONCLUSION: In patients with venous ulceration and isolated superficial venous incompetence, superficial venous surgery can produce ulcer healing in the majority of patients without the need for perforator surgery, postoperative compression bandaging or skin grafting.

Adult↗
PubMed1999

Vascular surgical society of great britain and ireland: role of superficial vein surgery in treatment of venous ulceration

BACKGROUND: Recent colour duplex studies of patients presenting with venous ulceration in the community have shown that between 55 and 60 per cent have isolated superficial venous insufficiency. Previous studies of the role of superficial surgery in the treatment of venous ulceration have applied postoperative compression bandaging and therefore it has not been possible to determine the role of superficial surgery in promoting ulcer healing. The purpose of this prospective study was, therefore, to examine the healing rate after superficial surgery in patients with isolated superficial venous incompetence and venous ulceration who did not undergo postoperative compression bandaging. METHODS: Patients with isolated superficial venous incompetence, as demonstrated by colour duplex scanning and an ankle : brachial pressure index greater than 0.8, underwent saphenofemoral or saphenopopliteal disconnection under local anaesthesia, or a high tie and strip under general anaesthesia. Compression bandaging was not applied after operation. Patients were followed regularly after surgery and the endpoint was ulcer healing. RESULTS: Between May 1994 and July 1997, 122 legs with venous ulceration and isolated superficial venous incompetence underwent superficial surgery. Ninety-three (76 per cent) had long saphenous incompetence alone, 13 (11 per cent) had short saphenous incompetence alone and 16 (13 per cent) had combined long and short saphenous incompetence. The median (range) patient age was 72 (28-94) years and the median duration of ulceration was 32 weeks (range 2 weeks to 32 years). The median (range) ulcer area was 9 (1-500) cm2. Ninety patients (74 per cent) had a local anaesthetic procedure while 32 (26 per cent) had general anaesthesia. Of patients who had long saphenous surgery, 69 had high ligation only and 24 had high ligation and strip. The healing rate by life-table analysis was 58 per cent at 6 months, 73 per cent at 1 year and 82 per cent at 18 months. Clinical review and colour duplex examination of patients with ulcers that had failed to heal (n = 18) showed that two had recurrent superficial to deep connections; the remainder had fixed ankle joints or severe osteoarthritis of the hip and knee. CONCLUSION: Superficial venous surgery in patients with isolated superficial venous incompetence and venous ulceration can achieve a very high healing rate in the absence of postoperative compression.

Journal Article↗
PubMed1999

Venous ulceration and continuous flow in the long saphenous vein.

OBJECTIVE: To determine the clinical significance of continuous flow in the long saphenous vein in limbs with venous ulceration. DESIGN: Retrospective review. PATIENTS AND METHODS: Review of 1608 consecutive limbs undergoing colour duplex scanning for venous disease over a 43 month period. RESULTS: Continuous flow in the long saphenous vein is seen in 8% of limbs with venous ulceration and in 37% of limbs with deep venous obstruction. Sixty-six per cent of ulcerated limbs with continuous flow in the long saphenous vein had deep venous obstruction, 27% had deep venous reflux with cellulitis and 7% had lymphoedema in addition to venous ulceration. CONCLUSION: Continuous flow in the long saphenous vein in patients with venous ulceration should alert the clinician to the possibility of deep venous obstruction. Such limbs should be treated by compression bandaging with extreme caution.

Blood Flow Velocity↗
PubMed1982

Research methodology. Needs assessment.

A review of the basic concepts in needs assessment and of the various ways in which needs assessment is performed with applications to clinical and health care programs is discussed in this article.

Planning Techniques↗