EFFECTIVE MANAGEMENT OF LOWER LIMB PHLEGMON: DOPPLER-GUIDED VENOUS CYANOACRYLATE CLOSURE
EFFECTIVE MANAGEMENT OF LOWER LIMB PHLEGMON: DOPPLER-GUIDED VENOUS CYANOACRYLATE CLOSURE

Summary/Abstract: Superficial venous insufficiency is a medical condition that can have a direct and significant impact on the appearance of redness, swelling, pain, and the development of sores and ulcers on the skin, which in some cases can progress to the development of phlegmon of the lower limb. This case report illustrates the effective management of severe lower limb phlegmon resulting from inadequate and enlarged superficial veins. The condition was successfully treated through noninvasive intravenous cyanoacrylate closure, guided by Doppler imaging, addressing the entire length of the great and small saphenous veins. A 36-year-old patient presented with severe phlegmon in the left leg for 2 years, accompanied by marked swelling, erythema, purulent ulcerative wounds, localized tenderness, and non-healing gangrenous wound on the second toe. Peripheral Doppler examination revealed an absent great saphenous vein in the femoral region (due to previous vein striping) and a dilated great saphenous vein in the distal femoral and crural regions, along with multiple dilated perforator vein branches and a small saphenous vein with a dilated perforator vein that communicates with the great vein in the crural region. A swab was taken from the patient’s wound, and it was proven that Staphylococcus hemolyticus was present. The patient was hospitalized and treated appropriately to reduce infection. Seven days after admission, the patient underwent Doppler-guided cyanoacrylate closure of the great saphenous vein in the left leg, followed by cyanoacrylate closure of the small saphenous vein nine days later. After two weeks, the patient exhibited significant clinical improvement, including pain relief, reduced lower leg swelling, diminished erythema, and complete wound healing of the second toe. This case illustrates the importance of timely diagnosis of superficial venous insufficiency and the success of treating the complications of the disease through modern noninvasive treatment.

• Details
• Contents