A 36-year-old man with a venous leg ulcer came to The Whiteley Clinic with his wife earlier this year. His left leg ulcer was agony. It was stopping him working normally and was making his life misery.
He had previously had some varicose vein surgery performed elsewhere which had made no difference.
The pain was ruining his life. He had been told that there was nothing more that can be done for his leg apart from compression therapy.
His wife had heard of the reputation of The Whiteley Clinic and the Whiteley Protocol approach to venous disease. She booked an appointment for her husband to see Prof Mark Whiteley.
The patient was in considerable pain. Standing and moving irritated the left leg ulcer.
As recommended by the National Institute of Health and Clinical Excellence (NICE) clinical guidelines CG 168, The Whiteley Clinic specialists work in teams. A The Whiteley Clinic trained vascular technologist performed a venous duplex ultrasound scan, which showed that despite attempted surgery elsewhere, there was still considerable hidden varicose veins. A lot of the great saphenous vein is still refluxing as. All of the small saphenous vein.
The patient underwent local anaesthetic, walk-in walk-out surgery. The treatment by the Whiteley Protocol used endovenous laser ablation and ultrasound guided foam sclerotherapy using the Whiteley-Patel technique.
The ulcer remained painful for the first few weeks after the treatment, as the healing process started. However slowly the ulcer completely disappeared and the skin became thicker and healthier.
On review 11 weeks after the local anaesthetic surgery, the patient bounded into the surgery completely pain-free. He said that his life had completely changed. The constant pain had disappeared allowing him to get on with normal life. He continued to carry an elasticated bandage which he would put on if he was going to stand for long period of time, even though he had been told that this was now not necessary. However having had painful such a long time, the patient felt that it would take some time for him to rebuild his confidence.
He was discharged, completely cured painful venous leg ulcer.
Approximately 500,000 people in the UK have recurrent venous leg ulcers, with approximately 125,000 being open and active at any time.
Traditionally venous leg ulcers have been treated by dressing and compression bandaging.
However research over the last couple of decades has shown that about 85% of venous leg ulcers can be cured. Most of these can be cured by simple local anaesthetic walk-in, walk-out surgery. Those that can’t, can sometimes be cured by opening deep veins using endovenous stents.
Although The Whiteley Clinic has been promoting this for well over a decade now, in July 2013 National Institutes of Health and Clinical Excellence came to the same conclusion and included this within its guidelines.
Anyone with a leg ulcer that has been present for more than two weeks should be referred to a specialist clinic such as The Whiteley Clinic. In this way, patients who have curable venous leg ulcers can be cured getting them back to normal life, leaving specialist tissue viability nurses to treat those that are truly incurable.