Vol. 7, Issue 1, Part B (2025)

Chronic venous ulcers are often treated with compression, debridement, and procedures targeting great saphenous vein reflux. This case highlights the successful use of Varithena foam sclerotherapy, stab phlebectomy, and excisional debridement to manage a refractory venous ulcer without great saphenous vein involvement. A 67-year-old man with chronic venous insufficiency and a 10-year non-healing medial ankle ulcer demonstrated secondary saphenous reflux with incompetent tributaries. This minimally invasive, multimodal intervention resulted in successful wound healing. The case underscores the potential role of targeting secondary venous pathways when great saphenous vein reflux is absent.