It is now possible to cure leg ulcers permanently, in the majority of cases, using local anaesthetic surgery. This sort of surgery is called “endovenous” surgery. It uses only needles and tiny incisions, not even big enough to need a stitch.
Endovenous surgery was introduced into the UK in March 1999 by Prof Mark Whiteley. Mark has championed the use of endovenous surgery for varicose veins, incompetent perforating veins and venous leg ulcers. He and his team have also championed a modification of this for pelvic congestion syndrome in women.
On 21 June 2017 Mark gave a talk to Age Concern, Croydon, on how to cure leg ulcers permanently.
Mark explained that most leg ulcers are venous in origin. He explained that most venous leg ulcers are caused by either varicose veins or “hidden varicose veins” that cannot be seen on the surface.
If patients with leg ulcers are investigated by using venous duplex ultrasound scanning, then the problem veins can be identified. These problem veins can then be ablated with endovenous techniques under local anaesthetic. In the majority of cases, using The Whiteley Protocol, this results in a permanent cure for leg ulcers.
Prof Mark Whiteley explained that dressings, or even fads such as Manuka honey or sugar, can be useful for skin wounds. Also, compression can be useful for venous leg ulcers. However, no dressing or compression can cure a venous leg ulcer permanent.
The reason for this is quite simple. As it is the hidden varicose veins that cause the venous leg ulcer, the ulcer cannot be cured until this underlying problem is fixed. No matter what is placed on the surface, the underlying problem remains. Hence the ulcer will recur when the dressings or bandages are removed.
Prof Mark Whiteley and his team developed The Whiteley Protocol to show how all venous conditions of the legs should be investigated and treated. They have been developing and refining this Protocol since 1999.
In summer 2013, the National Institute for Health and Care Excellence published their clinical guidelines CG 168 for varicose veins and it included leg ulcers (https://www.nice.org.uk/guidance/cg168/). These guidelines agreed with what The Whiteley Clinic had been promoting since 1999. This was that endovenous surgery is effective for varicose veins and leg ulcers and should be used in preference to stripping.
In 2013, The Whiteley Clinic published their 12-year results of healing venous leg ulcers. They showed they could cure leg ulcers using endovenous surgery in 85% of patients with venous leg ulcers. Over half of these have never needed any further help at all, not even a compression stocking! (https://thewhiteleyclinic.co.uk/research/published-research/permanent-cure-leg-ulcers-venous-surgery/)
Following on from his passion for making sure patients get the correct investigations and treatment for venous diseases, Mark founded the Leg Ulcer Charity (legulcercharity.org). He and his team now give talks around the UK, and occasionally abroad, to try and spread the word as to how it is possible to cure leg ulcers using local anaesthetic endovenous surgery.