Degloved foot sole successfully reconstructed with split thickness skin grafts.

Introduction: The current opinion is that split thickness skin grafts are not suitable to reconstruct a degloved foot sole. The tissue is too fragile to carry full bodyweight; and therefore, stress lesions frequently occur. The treatment of choice is the reuse of the avulsed skin whenever possible, or else the use of a full thickness fascio-cutaneus flap.

Randomised comparison of costs and cost-effectiveness of cryostripping and endovenous laser ablation for varicose veins: 2-year results.

Background: Although endovenous laser ablation for varicose veins is replacing surgical stripping, proper economic evaluation with adequate follow-up in a randomised clinical trial is important for considered policy decisions regarding the implementation of new techniques.

Methods: Data from a randomised controlled trial comparing cryostripping and endovenous laser ablation in 120 patients were combined to study Short Form (SF) 6D outcome, costs and cost-effectiveness 2 years after treatment. Incremental cost per quality-adjusted life year (QALY) gained 2 years after treatment was calculated using different strategies, and uncertainty was assessed with bootstrapping.

Randomized clinical trial comparing endovenous laser ablation of the great Saphenous vein with and without ligation of the sapheno-femoral junction: 2-year results.

Objective: To evaluate whether ligation of the sapheno-femoral junction (SFJ) improves the 2-year results of endovenous laser ablation (EVA).

Methods: Forty-three symptomatic patients with bilateral varicose veins were studied in which one limb was randomly assigned to receive EVA without SFJ ligation, and the other limb received EVA with SFJ ligation. Recurrence of varicose veins and abolition of great saphenous vein (GSV) reflux on duplex ultrasound imaging, and venous clinical severity score (VCSS) were investigated at 6, 12, and 24 months after treatment.

Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins.

Background: The aim of this randomized single-centre trial was to compare the 2-year results of endovenous laser ablation (EVLA) and cryostripping for varicose veins.

Methods: A total of 120 patients with uncomplicated great saphenous varicose veins were randomized equally to one of the two treatments. Principal outcomes measures were: freedom from recurrent varicose veins on duplex imaging, and improvement in Venous Clinical Severity Score (VCSS) and Aberdeen Varicose Vein Severity Score (AVVSS) 6, 12 and 24 months after treatment.

Endovenous laser ablation: an experimental study on the mechanism of action.

Objectives: The aim of this experimental study was to investigate the mechanism of action of endovenous laser ablation (EVLA) using an 810-nm diode laser.

Methods: We compared intermittent and continuous delivery of laser energy and studied the absorption of laser light by blood, intravascular temperatures in ex vivo human vein segments using an intravascular thermography catheter and heat dissipation in a model tissue using the Schlieren technique.

Results: Laser light is absorbed by blood and converted to heat leading to coagulation, vaporization and carbonization, and forming an isolating layer at the fibre tip.

Is there a risk for lymphatic complications after endovenous laser treatment versus cryostripping of the great saphenous vein? A prospective study.

Objective: To investigate whether lymphatic complications occur after endovenous laser treatment (EVLT) versus cryostripping.

Methods: A prospective analysis of patients who underwent lymphoscintigraphy before and six months after treatment of primary varicose veins.

Results: Of 120 patients randomized in a clinical trial comparing EVLT and cryostripping, 33 agreed to participate in this study.

Is there recanalization of the great saphenous vein 2 years after endovenous laser treatment?

Purpose: To report the 2-year single-center results of endovenous laser treatment (EVLT) for reflux in the great saphenous vein (GSV).

Methods: From January 2002 to January 2003, 85 symptomatic patients (56 women; mean age 49 years, range 27-80) underwent EVLT in 100 limbs. All patients were symptomatic, and the majority (67, 79%) had CEAP clinical class C2 venous disease.

Serious allergic reaction to administration of epirubicin.

A 47-year old woman was admitted for adjuvant treatment with chemotherapy consisting of epirubicin and cyclophosphamide. During the second course of chemotherapy an allergic reaction occurred after administration of epirubicin. Treatment with clemastine 2 mg iv caused a quick recovery and after 24 hours there was only a slight redness of the face.