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.

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 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.

A Randomised Controlled Trial of the Effect of Esmarch Tourniquet Use on Blood Loss, Bruising and Quality of Life in Elective Varicose Vein Surgery

2002 ◽  
Vol 17 (1) ◽  
pp. 10-12
Author(s):  
A. Fowler ◽  
M. Stechman ◽  
D. Mitchell
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Varicose Vein ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Varicose Vein Surgery ◽  
Clinical Value ◽  
Prospective Randomised Trial ◽  
Randomised Controlled

Objective: To assess the effect of tourniquet use on bleeding, bruising and quality of life in varicose vein surgery. Method: A prospective randomised trial of 49 patients undergoing varicose vein surgery was carried out. All patients were having single leg surgery as a day case. Blood loss was assessed by weighing swabs. Bruising was measured at 10 days, and quality of life assessed with SF36 questionaires. Synthesis: In the tourniquet group blood loss was significantly reduced but not the area of bruising. The SF36 scores showed deterioration in the non-tourniquet group at 10 days but this was not present at 6 weeks. We saw no complications of tourniquet use but the study was limited by disappointing recruitment reducing the power. Conclusion: Tourniquet use may be of clinical value. A larger study is required to assess the significance.

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.

A Rare Complication of Varicose Vein Surgery

2000 ◽  
Vol 15 (1) ◽  
pp. 43-45
Author(s):  
J. Herman ◽  
M. Lovecek ◽  
M. Duda ◽  
I. Svach
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Rare Complication ◽  
Iliac Vein ◽  
University Hospital ◽  
Varicose Vein Surgery ◽  
The Czech Republic ◽  
Long Saphenous Vein ◽  
Internal Iliac ◽  
Primary Varicose Veins

Design: Case report. Setting: University Hospital in the Czech Republic. Patients: Patient undergoing surgery for primary varicose veins. Interventions: The patient underwent attempted long saphenous vein stripping by passing a flexible stripper from ankle to groin. The stripper fractured at its upper end and a fragment of stripper became lodged in the internal iliac vein in the pelvis. This was removed at laparotomy. The patient made an uncomplicated recovery. Conclusion: Major complications of varicose vein surgery are rare. This unusual problem was probably caused by material fatigue in the stripper, leading to fracture near the upper end of the stripper.

Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

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.

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