Postoperative care after varicose vein surgery: patient-based questionnaire

2005 ◽  
Vol 20 (4) ◽  
pp. 190-192 ◽  
Author(s):  
T Tang ◽  
J R Boyle ◽  
M E Gaunt ◽  
K Varty
Keyword(s):  
Varicose Vein ◽  
Postoperative Care ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Walking Ability ◽  
Varicose Vein Surgery ◽  
Practical Advice ◽  
Pain Scores ◽  
Surgery Patient ◽  
The Mean

Objective: Practical advice given postoperatively to varicose vein patients remains subjective. They are encouraged to walk in their stockings or bandages as much as possible. The aim of this study was to investigate if this is a realistic request. Methods: A postal questionnaire was given to all patients undergoing varicose vein surgery from July 2003. The questionnaire referred to the following issues: pain scores, walking ability, stairs, driving, return to work, dressings and stockings. Results: A total of 93 patients replied, of which 55 (59%) were women and the mean age was 52 years (range 23–83). Of the patients who replied, 66 (71%) had a unilateral procedure and 13 (14%) had recurrent varicose veins. A total of 65 (70%) underwent a high tie, strip and avulsions, 16 (17%) underwent a short saphenous tie, nine (10%) underwent ligation of both saphenous systems and three (3%) underwent avulsions alone. Pain scores were low (3/10), resolving completely after nine days on average. Despite this, 89% of patients could only walk around the garden or block in the first week. After two weeks, normal activities were possible but most patients remained off work for three weeks. Stockings were a problem for 49 (53%) patients. Conclusions: Although we would like all our patients to mobilize early after varicose vein surgery, the traditional long walk is unrealistic. Support stockings cause difficulties in over half the patients. Postoperative care and advice for varicose vein surgery need re-thinking.

The early morbidity of varicose vein surgery

1995 ◽  
Vol 81 (1) ◽  
pp. 42-46
Author(s):  
D C Mackay ◽  
D J Summerton ◽  
A J Walker
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Population Group ◽  
Postal Questionnaire ◽  
Varicose Vein Surgery ◽  
Long Saphenous Vein ◽  
Case Surgery ◽  
Post Operation ◽  
The Difference ◽  
Considerable Morbidity

AbstractThe early outcome and morbidity associated with varicose vein surgery were assessed at six months post operation by postal questionnaire. Most cases underwent sapheno-femoral ligation, above-knee stripping of the long saphenous vein and multiple stab avul sions. A 73.8% response rate resulted in 155 replies, and revealed a high incidence (65.8%) of perceived complications within the first two weeks after surgery. The commonest of these were bruising, pain and numbness. Over a third of patients consulted their general practitioner (GP) postoperatively. Half of these required further management or treatment and the rest, reassurance alone. At six months 79.4 % were satisfied with the outcome of their surgery, although some still claimed problems with residual veins, skin discoloration, numbness, and ankle or foot disco loration. Eleven percent were referred to hospital for further opinion, mostly because of perceived residual varicose veins. The difference between residual and recurrent varicose veins is discussed. No patient fe lt that the standard 2.5 day admission was too long, and 12.9% thought it too short. Day case surgery is not a popular option in this population group.Despite high satisfaction rates, there is a considerable morbidity attached to varicose vein surgery. We believe that good pre- and perioperative communication, augmented by a comprehensive information sheet, is important to prepare patients for those postoperative problems and thus reduces their perceived importance.

Audit of varicose vein surgery: the patients' perspective

2005 ◽  
Vol 20 (4) ◽  
pp. 179-182 ◽  
Author(s):  
P S Sains ◽  
K M Reddy ◽  
H J S Jones ◽  
J K Derodra
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Surgical Patient ◽  
Varicose Vein Surgery ◽  
Patient Dissatisfaction ◽  
Modifiable Factors ◽  
Patients Perspective

Objectives: Varicose veins cause varying symptoms and post-surgical patient dissatisfaction is not uncommon. We aimed to identify patients' reasons for having surgery and sought to identify measures for improvement. Methods: A postal questionnaire was sent to patients. The patients' preoperative symptoms and postoperative satisfaction were enquired upon. Replies were cross-referenced to the operation notes. Results: Three hundred and thirty-five patients completed the questionnaire. The consultant carried out 73% of operations, with 27% being carried out by trainees. In all, 41% of patients were very satisfied with surgery, 39% were satisfied, 17% were dissatisfied and 4% were very dissatisfied. In those whose operation was carried out by a consultant, 18% were dissatisfied as compared with 31% of those operated on by a trainee. Conclusion: The vast majority of patients are satisfied with varicose vein surgery and there are modifiable factors such as grade of surgeon and supervision, which can influence the outcome and satisfaction.

The outcome of recurrent varicose vein surgery: the patients' perspective

2005 ◽  
Vol 20 (2) ◽  
pp. 57-59 ◽  
Author(s):  
A G Edwards ◽  
O Donaldson ◽  
C Bennetts ◽  
D C Mitchell
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Varicose Vein Surgery ◽  
Failure Group ◽  
Recurrent Varicose Veins ◽  
Success Group ◽  
The Mean ◽  
Patient’S Perception ◽  
Patients Perspective

Objectives: This study was performed to assess the patient's perception of the outcome of recurrent varicose vein surgery. Methods: Patients who underwent surgery for recurrent varicose veins between 1 January 1995 and 31 December 1998 were sent a questionnaire and Aberdeen Varicose Vein Severity Score (AVVSS) in September 2003. Results: A total of 48 questionnaires were distributed and 40 responses (83%) were received. The mean length of follow-up was 81.78 months. Outcome was 'excellent' (no varicose veins) for four patients, 'satisfactory' for 22 (small, asymptomatic recurrence), 'unsatisfactory' for 10 (symptomatic recurrence) and 'worse' for four patients; 65% thought that the outcome was successful (excellent or satisfactory) and 35% a failure. The median AVVSS in the success group was 11.50 (IQR 7.94–19.69) compared with 29.63 (IQR 18.46–40.31) in the failure group ( P = 0.0009, Wilcoxon). Conclusions: Two-thirds of patients undergoing surgery for recurrent varicose veins are satisfied with the outcome, nearly seven years after surgery. One-third will regard surgery as having failed. Patients should be advised of these potential outcomes prior to surgery.

Recurrence following Varicose Vein Surgery

2002 ◽  
Vol 16 (3) ◽  
pp. 101-105 ◽  
Author(s):  
D. D. I. Wright ◽  
K. G. Rose ◽  
E. Young ◽  
C. N. McCollum
Keyword(s):  
Varicose Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Consecutive Series ◽  
Varicose Vein Surgery ◽  
Recurrence Rates ◽  
Primary Surgery ◽  
Mean Time

Objective: To determine the site-specific rates of recurrence following varicose vein surgery. Design: Postal questionnaire followed up by telephone enquiries. Full clinical review, including continuous wave and duplex Doppler investigations were carried out for all patients with responses suggesting recurrence. Setting: Surgicare Manchester, an independent provider of specialist varicose vein treatments. All procedures were guided by Doppler ultrasound and performed by surgeons working to the same protocol. Subjects: A consecutive series of 250 operations on 246 Patients. Of these, 208 (85%) could be contacted for follow-up. Mean time to re-examination was 27 months. Results: Twelve patients returned spontaneously and 51 were recalled for examination based on questionnaire responses. Recurrences were divided into ‘site’, ‘perforator’ or ‘new site’ recurrence. Primary surgery to the sapheno-femoral junction (SFJ) had the lowest ‘site’ recurrence rate of 2.3% compared with 9.5% for SFJ re-operation. Primary surgery and re-operation of the sapheno-popliteal junction (SPJ) had higher recurrence rates of 8.3% and 7.8% respectively. New incompetence was detected in 5% and 2% of previously competent SFJ and SPJ respectively. Minor perforator incompetence was found in a further 14%. Conclusions: Varicose veins were progressive in some individuals, with new sites of incompetence appearing over time. However, ‘cure’ remains possible for most Patients and major recurrence can be reduced by Doppler diagnosis and precise surgery.

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.

Colour Flow Duplex Scanning as a Preoperative Guide for Mapping and for Local Anaesthesia in Varicose Vein Surgery

2000 ◽  
Vol 15 (1) ◽  
pp. 24-29 ◽  
Author(s):  
A. Cavezzi ◽  
V. Carigi ◽  
M. Collura
Keyword(s):  
Surgical Approach ◽  
Varicose Vein ◽  
Local Anaesthesia ◽  
Varicose Veins ◽  
Duplex Scanning ◽  
Outpatient Basis ◽  
Varicose Vein Surgery ◽  
Colour Flow ◽  
Surgery Patient ◽  
Clinical Series

Objective: To evaluate duplex or colour flow duplex ultrasound scanning (CFDS) in varicose vein surgery as a perioperative guide for mapping, marking and local anaesthesia (LA), on the basis of our experience since 1990. Design: Retrospective clinical series. Patients and methods: A total of 3150 interventions for varicose veins were performed on an outpatient basis since 1990. This review of the last 4 years' experience (January 1996 to December 1999) deals with 1824 operations (457 men, 938 women; mean age 55.3 years). Duplex scanning or CFDS was used for perioperative investigation in all the patients, but also to guide skin marking and to help in the injection of LA (mepivacaine chloridrate 0.25–0.4%). The surgical approach varied according to the patient's morphohaemodynamic findings. Results: Several different preoperative patterns of varicose vein disease resulted in a ‘made-to-measure’ surgical approach, allowing segmental saphenous stripping in 99.9% of the patients, and ligation of perforating veins in 0.9% of cases. Immediate postoperative walking was possible in 99.8% of the patients and 3–6 h hospitalisation time in 99.5%. LA caused only minor complications (haematoma, urticaria) in 15 cases. Duplex monitoring of infiltration has facilitated LA usage, decreasing the doses and concentrations required and improving its efficacy. The operation costs decreased with time; major complications were 2 deep vein thromboses, one with a probable pulmonary embolism. Conclusion: The use of duplex scanning or CFDS in varicose vein surgery has permitted accurate preoperative evaluation and a guide to injection of LA, resulting in more conservative and targeted surgery. Patient compliance and cost-efficacy were also improved.

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.

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.

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.

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