Ten years of experience with first-visit foam sclerotherapy to initiate venous ulcer healing.

OBJECTIVE:We evaluated the effect of first-visit foam sclerotherapy compared with scheduled treatment for patients with venous ulceration. METHODS:The study design was a retrospective comparative study. From December 2009 to October 2019, a total of 245 venous ulcers in 214 patients (including recurrent ulcers) were treated at Oulu University Hospital. Of these 245 venous ulcers, 143 were treated with first-visit foam sclerotherapy (group A) and 102 with scheduled treatment (group B). All patients received endovenous ablation (foam sclerotherapy and/or endothermal ablation) and compression therapy to promote venous ulcer healing. The primary outcome was the interval to ulcer healing, determined by Kaplan-Meier survival analysis. The secondary outcomes included the time to ulcer healing from the receipt of referral and ulcer recurrence. RESULTS:The median time to ulcer healing was 2.3 months for group A and 3.2 months for group B (P = .002). The estimated median ulcer healing times after referral for a first session of endovenous ablation were 2.7 months with a delay of <1 month from the referral, 3.3 months with a delay of 1 to 2 months, and 5.0 months with a delay of >2 months (P = .002). In group A, recurrent ulcers were recorded for 11 patients (7.7%). In group B, recurrent ulcers were recorded for 12 patients (11.8%; P = .281). CONCLUSIONS:The results of the present retrospective comparative study support first-visit foam sclerotherapy as an effective method to initiate endovenous ablation to promote venous ulcer healing. In venous ulcers, delays to endovenous ablation should be avoided whenever possible.