Hybrid management of chronic venous ulcer in severe venous insufficiency

Abstract

Introduction. Chronic venous ulcers have a significant impact on patients' quality of life, resulting in pain, limited mobility, exudative infections, and, in the most severe cases, lower limb amputations. Management should be multidisciplinary and individualized for each case, ensuring optimal patient improvement. Objective. To implement hybrid venous ulcer management for definitive closure in a single surgical procedure. Clinical Case. A 72-year-old woman with a chronic venous ulcer of twenty years' duration, receiving multiple pharmacological and chronic wound management treatments. A thorough clinical evaluation and ultrasound were performed, and a decision was made to select hybrid resolution, correction of venous reflux, chemical ablation with ultrasound-guided foam, and stamp grafting for ulcer coverage. Results. The ulcer was closed immediately and healed within twenty days, with complete reversal of peripheral symptoms. Conclusion. Hybrid surgery, when performed systematically and with coverage of skin defects in the initial surgical procedure, is feasible with excellent results, a significant decrease in morbidity and mortality, and a substantial improvement in quality of life.