Title: Our experience with subfascial perforator vein ligation by Cockett and Dodd in perforator incompetence of varicose veins
Authors: Dr Reny Jayaprakas, Dr Vishal Raj, Dr G. Ambujam
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.63
Abstract
Aims and Objectives
- To study the role of subfascial perforator vein ligation by Cockett and Dodd in perforator incompetence of varicose veins.
- To study the complications following the procedure.
Materials and Methodology: prospective study was conducted in the period between August 2015 and August 2017 in the department of General Surgery in Vinayaka Missions Medical college, Karaikal. 32 cases of varicosities of the lower limbs with perforator incompetence with or without Saphenofemoral incompetence were included in the study.
Observation and Results: Our study had 20 males and 12 females. Commonest age group affected was 41- 50 (43.25%). The most common presentation of the patients was ulcers (56.25%), followed by pain, skin changes etc. The left (53.1%) side was more commonly involved, bilateral disease was noted in 2 cases (6%). Perforator ligation alone was performed in 14 cases (42.75%), whereas combined perforator ligation with stripping +/- Saphenopopliteal ligation was done in 18 cases(56.25%). Post operatively shorter hospital stay was noted in the group with perforator ligation alone- average of 6.4 days, 9.3 days for the cases with combined procedure. Residual perforator incompetence was seen in 2 cases (6.25%). Postoperative wound infection was seen in 2 cases (6.25%). Delayed wound healing in 1case (3.12%).
Conclusion: Open perforator ligation (Cockett and Dodd’s) has been largely replaced by SEPS procedure in many centres around the world. But, open subfascial perforator ligation is a useful, effective procedure in treatment of patients with primary varicose veins with perforator incompetence, particularly in centres, which lack the facilities for endoscopic procedure.
Keywords: subfascial perforator ligation, perforator incompetence, varicose veins.
