COMPARISON OF FOAM SCLEROTHERAPY AUGMENTED PHLEBECTOMY VERSUS AMBULATORY PHLEBECTOMY IN THE MANAGEMENT OF ISOLATED BELOW KNEE INCOMPETENT PERFORATORS

Background & Objectives:Among the patients who underwent Foam Sclerotherapy Augmented Phlebectomy (FSAP) and Ambulatory Phlebectomy (AP) a) To determine the number(proportion) patient seeking for post operative pain (greater than 3 according to visual analog scale in 1 months of procedure) b) To determine median number of days to resume normal activities c) To assess the healing of venous ulcer using CEAP classification and revised venous clinical severity scoring system. d) To identify any recurrence at the same site of Earlier Phlebectomy (FSAP or AP) using duplex scan after 6 months of procedure Methods: Patients satisfying inclusion criteria are enrolled within 24 hrs of admission afterinformed consent. All the patients with isolated below knee perforator incompetence will be evaluated with through clinical examination, radiological and laboratory investigations. Those who require surgery will be admitted and appropriate surgery will be performed and analyzed for in term of post operative pain, operative time, hospital stay, number of days to resume normal activities, healing of venous ulcer, recurrence. Results: Majority of patients belonged to the age group 41- 50 years. M: F is66% males and 34% females. number of days to resume normal activities by the patient mean days among FASP group 9.4% and AP group is 12.8%Post Procedure VAS pain score in 1 month among study participants mean vas score among Foam Sclerotherapy Augmented Phlebectomy 4.5% and Ambulatory Phlebectomy 5.1%length of hospital study in FSAP group mean 5.1% and in AP group 5.3%, Recurrence among the patients underwent FSAP group 4.7% and in AP group 14.5%. Interpretation & Conclusion:FSAP is associated with less post operative pain, shorter duration pf hospital stays and a quicker recovery, shorter duration of surgery, earlier return to work and not associated with major postoperative complications. There is less recurrence in FSAP compared with AP in the follow up period of six months.