The Role of Subfascial Ligation of Perforator Veins By Cockett And Dodd Method in the Treatment of Varicose Veins
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
Aims And Objectives 1. To study the role of Cockett and Dodd operation of subfascial ligation of below knee perforator veins in the treatment of varicose veins of the lower limb. 2. To study the results and the incidence of various complications after the Cockett and Dodd operation. Materials And Methods This prospective study is based on the analysis of 26 cases of varicosities of the lower limbs with perforator incompetence with or without saphenofemoral incompetence. The patients were treated with perforator ligation alone with the Cockett and Dodd method or in combination with the stripping procedure. The study was conducted in the period between August 2014 and August 2015. Results: A total of 26 patients underwent the Cockett and Dodd procedure in the MEDICITI INSTITUTE OF Medical Sciences from August 2014 to August 2015 Of the 26 patients who underwent the procedure, 23 were men and 3 were women Of the patients operated, 42.3% (n=11) had only perforator incompetence and 57.7% (n=15) had either saphenofemoral or saphenopopliteal incompetence in addition to perforator incompetence. The patients with isolated perforator incompetence were treated with the Cockett and Dodd procedure whereas the patients with concomitant saphenofemoral incompetence underwent stripping operation in addition to subfascial ligation In our study, postoperative wound infection of the long posterior leg incision was seen in 11.5% (n=3) of the patients. Delayed wound healing without infection was seen in 3.8% (n=1). In no patients, wound hematoma or nerve palsy (motor or sensory neuropathy) was seen In our study, wound infection and non healing rates were less than the described in literature. This is probably the result of careful patient selection The mean ulcer healing time in our study was 3.11 weeks following surgery . Earliest healing time was 6 days and the longest time was 8 weeks. Ulcer healing time quoted in literature ranges from 2 to 6 weeks the average being 35 days The mean postoperative stay for patients undergoing Cockett and Dodd procedure alone was 5.4 days. The mean postoperative stay for patients who underwent perforator ligation with concomitant stripping procedure was 8.2 days Conclusion: Cockett and Dodd procedure of open subfascial perforator ligation is a useful procedure in treatment of patients with primary varicose veins with perforator incompetence. The most feared local wound complications of the procedure can be prevented by careful patient selection, meticulous operative technique and assiduous postoperative care. With these precautions, the wound complications can be minimized and acceptable results can be achieved. Open perforator ligation has an important role in treatment of venous ulcers with our study showing 100% ulcer healing rates within 8 weeks of the procedure.
Authors and Affiliations
Dr. S. Naresh Kumar, Dr. M. Shirisha
Keywords
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- EP ID EP597016
- DOI 10.9790/0853-1605030918.
- Views 50
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