Post-treatment compression: duration and techniques

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 21-24 ◽  
Author(s):  
G Mosti
Keyword(s):  
Postoperative Pain ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Standing Position ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
Compression Bandaging ◽  
Compression Bandages ◽  
Eccentric Compression

Background: Compression treatments used the following intervention for varicose veins range from no compression, to elastic stockings and compression bandaging. There is no consensus on the strength or duration of compression which should be applied following a particular treatment. The author reviews the evidence that has led him to reach his own viewpoint on this subject. Summary: Compression stockings are often prescribed after treatment of varicose veins, but these in general exert a much lower pressure in the thigh compared with firm inelastic compression bandages. It has been shown by objective investigation that it takes a pressure of 10–15 mmHg in the supine position and 40–50 mmHg in the standing position to occlude a superficial vein in the thigh. The author has published a study in which three groups of patients were studied following varicose vein surgery. One group received a strong medical compression stocking, the second group an inelastic bandaging system which achieved 63 mmHg compression in the standing position and an eccentric compression system which achieved 98 mmHg in the standing position. Adverse events after surgery were most frequent in the stocking group with fewer in the inelastic compression bandage group and fewest in the eccentric compression group. A further study has been published by another author in which elastic compression has been compared with eccentric compression following endovenous laser ablation of the saphenous vein. Eccentric compression reduced postoperative pain. Unfortunately, very little data are available to indicate the period for which compression should be applied following varicose vein treatment. Conclusions: In comparison to compression treatments following varicose vein surgery where the actual level of compression has been measured, higher levels of compression are more effective than lower levels in moderating postoperative pain and complications. Strong compression can be achieved by inelastic bandaging or by eccentric compression systems. Far fewer data are available to indicate the duration for which postoperative compression is required.

Varicose Veins: optimum compression after surgery and sclerotherapy

1990 ◽  
Vol 76 (2) ◽  
pp. 101-104
Author(s):  
P. J. Shouler ◽  
P. C. Runchman
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
High Compression ◽  
Graduated Compression Stockings ◽  
Non Surgical Treatment

SummaryGraduated compression stockings are used in both surgical and non-surgical treatment of varicose veins. In a trial of high versus low compression stockings (40mmHg vs 15mmHg at ankle) after varicose vein surgery, both were equally effective in controlling bruising and thrombophlebitis, but low compression stockings proved to be more comfortable.In a further trial after sclerotherapy, high compression stockings alone produced comparable results to Elastocrepe® bandages with stockings. It is concluded that after varicose vein surgery low compression stockings provide adequate support for the leg and that after sclerotherapy, bandaging is not required if a high compression stocking is used.

scholarly journals Modification of varicose vein stripping to achieve immediate compression in a theatre setting with minimum personnel

2020 ◽  
Vol 7 (10) ◽  
pp. 3418
Author(s):  
Joseph Francis ◽  
Nihaz Y. Nazer
Keyword(s):  
Varicose Vein ◽  
Single Layer ◽  
Cost Effective ◽  
Compression Stocking ◽  
Silk Suture ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
Modified Technique ◽  
Below The Knee ◽  
Compression Bandaging

Compression bandaging is a key aspect following stripping for varicose vein surgery. With adequate compression, formation of subcutaneous hematoma can be prevented and thereby prevent revascularisation of the hematoma leading to recurrence of varicose vein. Various techniques exist to provide compression. Our modification provides an easy alternative to achieve immediate compression following stripping and is especially useful in a setting where staff is very limited. Materials required include a 10 cm width gauze bandage, 1% lidocaine with epinephrine, and number 1 silk suture in addition to the conventional tools for open varicose vein surgery. The gauze bandage is introduced along with the stripper which is passed from groin to below knee. The bandage is kept in the subcutaneous tunnel till perforator ligation, groin wound closure and application of compression bandage. The gauze bandage is removed through a small window within the compression stocking below the knee and the wound closed in a single layer. From 2005 to 2020, 410 patients underwent varicose vein surgery with the modified technique. Of these, 1 patient developed complication secondary to hematoma formation which was managed conservatively. Our modification of the varicose vein stripping technique is shown to be a cost effective and simple technique which provides immediate compression and effortlessly facilitates haemostasis till wounds are closed and compression stockings applied. in various literatures.

A Simple Technique to Reduce Blood Loss and Improve Cosmesis in Varicose Vein Surgery

1998 ◽  
Vol 13 (4) ◽  
pp. 153-156
Author(s):  
A. Rehman ◽  
V. S. P. Rallapalle ◽  
R. Iqbal ◽  
R. P. Grimley ◽  
A. P. Jayatunga
Keyword(s):  
Blood Loss ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Operation Time ◽  
Cosmetic Result ◽  
Compression Stocking ◽  
Varicose Vein Surgery ◽  
Cosmetic Results ◽  
Group A ◽  
Group B

Objective: To assess the effectiveness of preoperative compression hosiery in reducing blood loss during surgery for varicose veins and improving cosmetic results. Setting: Vascular Surgical Unit, Dudley Group of Hospitals NHS Trust, West Midlands, UK. Design: Randomized, single-blind, prospective, controlled trial. Patients: Thirty-nine patients with varicose veins in 50 legs. Intervention: Group A, the control group ( n = 19), were given compression stockings on the first postoperative day after the bandages were removed. Group B, the study group ( n = 20), used compression stocking 24 h before surgery as well as in the postoperative period. The surgical procedure was standardized. Main outcome measures: Blood loss, weight of veins removed, operation time and cosmetic result after 6 weeks. Results: In group B, patients were noted to have reduced blood loss, a shorter operation time and a greater weight of avulsed veins. Poor cosmetic results were recorded in group A. Conclusions: Preoperative emptying of veins by using a compression stocking is useful in reducing blood loss and improving the cosmetic result after routine varicose vein surgery.

There is No Benefit from 6 Weeks' Postoperative Compression after Varicose Vein Surgery: A Prospective Randomised Trial

1999 ◽  
Vol 14 (1) ◽  
pp. 21-25 ◽  
Author(s):  
M. G. T. Raraty ◽  
M. G. Greaney ◽  
S. D. Blair
Keyword(s):  
Clinical Assessment ◽  
Varicose Vein ◽  
Statistical Difference ◽  
Varicose Veins ◽  
Randomised Trial ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
Prospective Randomised Trial ◽  
Primary Varicose Veins ◽  
To Receive

Background: It is often recommended that patients should wear compression stockings for 6 weeks after varicose vein surgery. The aim of this trial was to ascertain whether this is necessary. Method: Following a standardised operation for primary varicose veins, patients were randomised to receive postoperative compression with either Panelast Acryl adhesive short-stretch bandages for 1 week or crepe bandages for 16 h followed by 6 weeks wearing of TED antiembolic stockings. Symptoms were quantified by questionnaire and clinical assessment at 1 and 6 weeks. Results: Postoperatively there was significantly more bleeding in the crepe/TED group and a larger area of bruising at the end of the first week (117.5 cm2 vs. 96 cm2, p<0.02; Mann–Whitney U-test). However, this did not correlate with any difference in discomfort or activity between the two groups. There was no statistical difference in the symptoms reported after the first week. Twenty-seven patients out of 52 randomised to TEDs discarded them before the end of the 6 weeks. Both groups returned to full activities and work after similar periods (Panelast 18.5 days vs. crepe 20.0 days). Conclusion: There was no benefit in wearing compression for more than 1 week. Wearing Panelast bandages for the first week did significantly reduce pain on the first postoperative day, bleeding and the extent of bruising.

Optimum Methods of Limb Compression following Varicose Vein Surgery

1987 ◽  
Vol 2 (3) ◽  
pp. 165-172 ◽  
Author(s):  
P.D. Coleridge Smith ◽  
J.H. Scurr ◽  
K.P. Robinson
Keyword(s):  
Varicose Vein ◽  
Testing Machine ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
The Poor ◽  
High Compression ◽  
Limb Compression

It has been shown that bandages rapidly lose their ability to compress the leg in ambulant patients. However, they are still widely used following varicose vein surgery. We have measured the compression produced by crepe bandages, elastocrepe bandages or graduated high compression stockings following varicose vein surgery. Pressures exerted by the bandages and stockings were measured during the first 24 h following operation. Initially the bandages exerted greater pressures than the stockings. However, the bandaging techniques lost 13-38% of their compression in the first hour and 29–48% in 24 h compared with 3-5% for the compression stocking. Further testing of the bandages on a standard wooden leg and a commercial fabric testing machine confirmed that the loss of compression in the bandaged groups was due to the poor elastic qualities of crepe and elastocrepe bandages. The stockings provided a more constant compression with maintained graduation compared with the bandages.

A Randomised Trial of Different Compression Dressings following Varicose Vein Surgery

1999 ◽  
Vol 14 (1) ◽  
pp. 9-11 ◽  
Author(s):  
R. Bond ◽  
M. R. Whyman ◽  
D. C. Wilkins ◽  
A. J. Walker ◽  
S. Ashley
Keyword(s):  
Postoperative Pain ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Randomised Trial ◽  
The Other ◽  
Varicose Vein Surgery ◽  
Personal Preference ◽  
Pain Scores ◽  
To Receive ◽  
Daily Pain

Objective: TED antiembolism stockings, Panelast self-adhesive elasticated bandages and Medi Plus class II stockings are three different dressings commonly used to provide compression following surgery for varicose veins. The aim of this study was to determine which of the three dressings was most acceptable to patients. Design: Forty-two patients undergoing bilateral varicose vein surgery were randomised to receive a different dressing on each leg in order to determine if a particular type of dressing was superior in its ability to reduce postoperative pain and provide adequate comfort without reducing mobility. The dressings were worn for 1 week, during which daily pain scores were recorded for each leg followed by a simple questionnaire to determine comfort and mobility. Results: There was a significant reduction of mobility experienced by patients wearing Panelast bandages compared with the other two dressings ( p<0.05). However, there were no significant differences between the dressings with regard to the degree of postoperative pain experienced, and in all other respects the dressings were equally tolerated. Conclusion: The choice of compression dressings used for varicose vein surgery should depend primarily on the personal preference of surgeons as well as financial considerations.

Varicose vein surgery under anti-platelet therapy

Phlebologie ◽  
2008 ◽  
Vol 37 (06) ◽  
pp. 287-297 ◽  
Author(s):  
P.-M. Baier ◽  
Z. T. Miszczak
Keyword(s):  
Varicose Vein ◽  
Bleeding Time ◽  
Varicose Veins ◽  
Bleeding Risk ◽  
Bleeding Complications ◽  
Review Of The Literature ◽  
Varicose Vein Surgery ◽  
Anti Platelet Therapy ◽  
Male Patients ◽  
Acute Atherothrombosis

Summary Background: Platelet function inhibitors (PFI) are used for prophylaxis of atherothrombosis. These drugs cause a prolongation of the bleeding time and should eventually be stopped before an elective operation. However, there is a risk that a perioperative pause of PFI lead to acute atherothrombosis. Objective: Our aim was to study whether a discontinuation of PFI therapy is necessary to avoid bleeding complications in patients undergoing varicose vein surgery. Methods: Selective review of the literature and retrospective analysis of clinical data of our own patients. Results: In the years 2002 to 2007 a total of 10 827 patients have been operated on varicose veins, 673 (6.2%) of these aged 32–86 years (67 ± 7.9) receiving permanent PFI therapy: 256 male patients (38.0%) and 417 female (62.0%), 39.1% categorized as ASA III patients: male 11.6%, female 27.5%. 38 patients who continued PFI therapy did not demonstrate haemorrhagic complications and none of those pausing anti-platelet medication experienced thromboembolic complications. The literature survey confirmed our finding that it is not necessary to suspend PFI medication for varicose vein surgery as the bleeding risk can be controlled for by technical means. Conclusion: Discontinuation of PFI therapy prior to interventions on varicose veins does not seem to be necessary, further studies are essential though.

Recurrent varicose veins below the knee after varicose vein surgery

Phlebologie ◽  
2007 ◽  
Vol 36 (03) ◽  
pp. 132-136
Author(s):  
M. W. de Haan ◽  
J. C. J. M. Veraart ◽  
H. A. M. Neumann ◽  
P. A. F. A. van Neer
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Varicose Vein Surgery ◽  
Proximal Point ◽  
Perforating Veins ◽  
Recurrent Varicose Veins ◽  
Below The Knee ◽  
Duplex Imaging ◽  
Additional Value

SummaryThe objectives of this observational study were to investigate whether varicography has additional value to CFDI in clarifying the nature and source of recurrent varicose veins below the knee after varicose vein surgery and to investigate the possible role of incompetent perforating veins (IPV) in these recurrent varicose veins. Patients, material, methods: 24 limbs (21 patients) were included. All patients were assessed by a preoperative clinical examination and CFDI (colour flow duplex imaging). Re-evaluation (clinical and CFDI) was done two years after surgery and varicography was performed. Primary endpoint of the study was the varicographic pattern of these visible varicose veins. Secondary endpoint was the connection between these varicose veins and incompetent perforating veins. Results: In 18 limbs (75%) the varicose veins were part of a network, in six limbs (25%) the varicose vein appeared to be a solitary vein. In three limbs (12.5%) an incompetent sapheno-femoral junction was found on CFDI and on varicography in the same patients. In 10 limbs (41%) the varicose veins showed a connection with the persistent below knee GSV on varicography. In nine of these 10 limbs CFDI also showed reflux of this below knee GSV. In four limbs (16%) the varicose veins showed a connection with the small saphenous vein (SSV). In three limbs this reflux was dtected with CFDI after surgery. An IPV was found to be the proximal point of the varicose vein in six limbs (25%) and half of these IPV were detected with CFDI as well. Conclusion: Varicography has less value than CFDI in detecting the source of reflux in patients with recurrent varicose veins after surgery, except in a few cases where IPV are suspected to play a role and CFDI is unable to detect these IPV.

Day Case Varicose Vein Surgery: Patient Health Outcome

2001 ◽  
Vol 16 (4) ◽  
pp. 160-163
Author(s):  
K. J. Sweeney ◽  
T. Cheema ◽  
S. O'Keefe ◽  
S. Johnston ◽  
P. Burke ◽  
...  
Keyword(s):  
Physical Function ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Well Being ◽  
Health Perception ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Population Norms ◽  
Patient Health ◽  
The Impact

Background: The success of day case varicose vein surgery (DCWS) is traditionally denned clinically. However, the patient's perception of his or her own health prior to and following DCWS has not been established. This study prospectively measured the health status of patients with varicose veins, compared this with established population norms and assessed the impact of DCWS on both general health perception and varicose vein symptoms. Method: Fifty-three consecutive patients undergoing DCWS over a 9 month period were enrolled in this study. The SF-36 health assessment questionnaire and a vein-symptom-specific questionnaire were administered on the morning of surgery, 7 weeks postoperatively and 1 year following surgery. All patients in this study underwent a standard varicose vein operation and followed a standard protocol of postoperative management. Results: DCWS population health scores were lower than general population norms preoperatively. There was a significant improvement in the 7 week postoperative group in physical function and health perception (p<0.05). One year after surgery physical function, health perception, mental health and physical role were significantly improved from preoperative scores (p<0.05). Symptom-specific scores demonstrated a sustained trend towards improvement over the postoperative year. Conclusion: Varicose veins are associated with diminished well-being. Day case varicose vein surgery improves patient health perception and symptoms and is the treatment of choice for suitable patients with varicose veins.

Day-Case Surgery: A Viable Alternative for Surgical Treatment of Varicose Veins

1987 ◽  
Vol 2 (2) ◽  
pp. 103-108 ◽  
Author(s):  
D.C. Berridge ◽  
G.S. Makin
Keyword(s):  
Patient Group ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Viable Alternative ◽  
Patient Treatment ◽  
Case Group ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Day Case Surgery ◽  
Case Surgery

One hundred and forty-eight patients (164 limbs) who had varicose vein surgery by the same consultant surgeon 3–10 years previously were reviewed; 61 patients had surgery as an in-patient and 87 as a day-case. The patients were reviewed to assess the efficacy and acceptability of day-case varicose vein surgery. There were no significant differences between the age and sex ratios of the patients. However, twice as many operations in the in-patient group included stripping of the long saphenous vein above the knee (χ2 = 4.2, P = 0.04). Fifteen in-patients had bilateral vein surgery as opposed to only one day-case patient. Fifteen patients suffered complications most of which were minor and were evenly distributed including wound infections (nine), reactionary haemorrhage/haematoma (four), deep vein thrombosis (one) and pulmonary embolus (one). The convalescent period before returning to work was similar in the two groups (U= 953, P= 0.28). The mean duration of stay for the in-patients was 3.9 ± 2.2 days. There was no significant difference in the period off work (day-case: 3.6 ± 2.0 weeks; in-patient: 4 ± 2.9 weeks), or in the length of follow-up (day-case: 6.01 ± 1.24 years; in-patient: 6.79 ± 1.71 years). In the period before review 11 patients in the in-patient group and 13 patients in the day-case group had further surgery or sclerotherapy for recurrent symptomatic varicose veins. At review five patients in the in-patient group and six patients in the day-case group had recurrent sapheno-femoral incompetence (χ2 = 0.1, P = 0.7). A total of 34 patients in both groups had recurrent varicose veins. Only four (4.6%) of the day-case patients expressed a preference for in-patient treatment if they were to have further surgery and 21 (34%) of the in-patient group would prefer day-case surgery. Day-case varicose vein surgery has not been shown to be inferior in terms of complications or recurrence rate. Patient acceptability is good and it is a viable alternative to in-patient treatment in suitable patients in areas with adequate district nurse facilities.

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