The History of Sclerosing Foams

702 WOLLMANN: THE HISTORY OF SCLEROSING FOAMS Dermatol Surg 30:5:May 2004
osant:air ratios, or pump procedures make the foam
less stable and less viscous.
The first prospective, randomized multicenter study
compared foam sclerotherapy with double-syringe
system with conventional fluid sclerotherapy in 88
patients with greater saphenous vein insufficiency. A
single injection (the protocol did not include further
injections) of 2 to 2.5 mL of double-syringe-system
foam or 3% liquid polidocanol showed a 2-year
occlusion rate of 84% in the foam group versus 40%
in the fluid group. Vasospasm was clearly more
frequent and more pronounced in the group treated
with foam (mean length 28 cm) than in the control
group, the rate of side effects being identical. 11,12
Conclusion and Discussion
The use of foamed sclerosing agents in therapy of large
or small varicose veins is not new. It started as early as
1939. The publications about foam sclerotherapy
found and presented in this text allow us to look at
what has been invented between the very beginnings
and now. The contributions of widely known and also
of less known colleagues show that remarkable work
was performed in the field of noncommercial foam
sclerotherapy continuously for the past six decades,
especially for the treatment of varicose veins of the
lower limbs. But they also show that there sometimes
is a lack of accuracy in describing the particular foams
used, which does not make it easy to reproduce the
individual reported results and/or findings. The suggestion
therefore is to describe any foam used in
nonclinical or clinical trials according to the ‘‘definition
of sclerosing foams’’: Sclerosing foam is characterized
by (at least) the following variables: type and
concentration of the tensioactive sclerosing agent, type
of gas, ratio of liquid to gas, the method of
preparation, the time between processing and use,
and bubble sizes. This could really help to make
sclerosing foams, and clinical results, comparable.
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