Successful treatment of "non-healing" venous leg ulcers by shave therapy

41 patients with 75 recalcitrant leg ulcers caused by primary deep vein incompetence or postthrombosis, who were operated by shave therapy (removal of ulcer and surrounding lipodermatosclerosis with a Schink skin grafting knive and covering of the wounds with meshed split-thickness skin grafts), were evaluated after an average followup period of 2 years and 5 months. All ulcers classified as nonhealing showed a healing rate of 67% (50 of 75 ulcers). The prognosis was more favourable in ulcers associated with primary deep vein incompetence (healing rate: 76%) compared to ulcers in postthrombosis (healing rate: 58%). In cases with recurrencies (33%) these ulcers were strikingly reduced by 80-90% of their original size. Hypaesthesia was noticed in 38% of the transplanted areas. In "non-healing" venous leg ulcers due to deep venous insufficiency shave therapy yields favourable long-term results. Because it is only a symptomatic treatment which does not reduce the pathological refluxes, continuous compression of the lower leg is important.