COMPARATIVE STUDY OF OUTCOME OF VENOUS ULCER IN PATIENT WITH PERFORATOR INCOMPETENCE VS SAPHENOFEMORAL JUNCTION INCOMPETENCE

Abstract

Introduction: Venous ulcers are a common manifestation of chronic venous insufficiency (CVI), with various underlying pathophysiological mechanisms contributing to their development. Understanding the differences in outcomes between venous ulcers associated with perforator incompetence and those associated with saphenofemoral junction (SFJ) incompetence is crucial for optimizing management strategies and improving patient care. Objective: This study aimed to compare the outcomes of venous ulcers in patients with perforator incompetence versus those with SFJ incompetence through a comprehensive analysis of clinical parameters and treatment responses. Methods: A retrospective comparative study was conducted, involving patients with venous ulcers presenting to the Saveetha medical college and hospital  vascular clinic. Patients were categorized into two groups based on the underlying venous pathology: the perforator incompetence group and the SFJ incompetence group. Clinical data, including ulcer characteristics, healing rates, recurrence rates, and treatment modalities, were collected and analyzed. Results: A total of 40 patients with venous ulcers were included in the study, with 20 patients in the perforator incompetence group and 20 patients in the SFJ incompetence group. Comparison of clinical outcomes revealed distinct differences between the two groups. Patients with perforator incompetence demonstrated shorter healing times and lower recurrence rates compared to those with SFJ incompetence. Furthermore, adjunctive therapies such as compression therapy and wound dressings were found to be more effective in patients with perforator incompetence. Conclusion: This comparative study provides valuable insights into the outcomes of venous ulcers associated with different underlying venous pathologies. Venous ulcers related to perforator incompetence exhibit more favorable clinical outcomes, including faster healing and lower recurrence rates, compared to those associated with SFJ incompetence. Tailoring treatment strategies based on the underlying venous pathology may lead to improved outcomes and enhanced patient satisfaction. Further prospective studies are warranted to validate these findings and elucidate the underlying mechanisms driving differences in outcomes between the two groups.