scholarly journals Effect of Compression Stockings after Endovenous Laser Ablation of the Great Saphenous Vein with a 1470 nm Diode Laser Device and a 2ring Fiber

2021 ◽  
Vol 10 (17) ◽  
pp. 3861
Author(s):  
Laura Fischer ◽  
Uldis Maurins ◽  
Eberhard Rabe ◽  
Juris Rits ◽  
Arnolds Kadiss ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Diode Laser ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Post Intervention ◽  
Endovenous Laser Ablation ◽  
Pain Scores ◽  
Group A ◽  
The Difference ◽  
Group B

The aim of this study was to demonstrate the effects of compression following the endovenous laser ablation (EVLA) of incompetent great saphenous veins (GSVs) using a 1470 nm diode laser (Ceralas E 1470 nm, biolitec) and a 2ring radial fiber (ELVeS Radial 2ring™, biolitec). In this single-center prospective study, 150 legs of 150 consecutive patients were randomly allocated to one of three groups (A, B, and C). Group A patients did not undergo postoperative compression. Group B patients wore a thigh-length graduated compression stocking (23–32 mmHg) for 7 days, whereas group C patients wore the same stocking for 28 days. No additional phlebectomies or sclerotherapies were performed. Investigations were performed prior to intervention, at the day of intervention (D0), at day 7 (D7), and at day 28 post intervention (D28). The primary endpoint was post-interventional pain measured on a 10-point scale. A significant but small pain decrease was observed in the first week of compression, by comparing group B’s mean pain scores to those of group A (p = 0.009). Wearing a compression stocking after EVLA reduced pain within the first week on a significant, but low level. Taking the very low differences in pain levels into account, the difference may not be clinically relevant and post-treatment compression may not be necessary if no additional phlebectomies or sclerotherapies are performed.

Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser

2013 ◽  
Vol 30 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Mert Dumantepe ◽  
Ibrahim Uyar
Keyword(s):  
Laser Ablation ◽  
Side Effects ◽  
Room Temperature ◽  
Pain Perception ◽  
Visual Analog Score ◽  
Ablation Procedure ◽  
Endovenous Laser Ablation ◽  
Fluid Infiltration ◽  
Group A ◽  
Group B

Objective: The aim of this study was to compare the pain perception and side effects during and after endovenous laser ablation with a 1470 nm diode laser using cold or room temperature tumescence anesthesia. Methods: One hundred and one patients were randomly assigned in two groups. Group A received room temperature (+24℃) and Group B received cold (+4℃) tumescence fluid, which was used for local anesthesia in the track of great saphenous vein. A visual analog score was recorded immediately after the procedure. Patients were asked to register pain scores and the amount of pain medication consumed during the week. Results: There was no significant difference concerning gender, age, Clinical Etiological Anatomical Pathological Classification, body mass index, or diameter of the treated vein. In Group A, the mean linear endovenous energy density was 59.5 J/cm and in Group B, it was 60.4 J/cm. The average visual analog score after the endovenous laser ablation procedure in Group A was 5 and in Group B was 2. Third day after the procedure, the average visual analog score in Group A was 3 and in Group B was 1. Patients in Group B needed significantly less analgesics compared with patients in Group A ( p<0.05). The most frequent side effects in both groups were ecchymosis, induration, and minor paraesthesia, all of which were more common in Group A ( p < 0.001). Conclusions: To date, most published endovenous laser ablation series describe the use of room temperature tumescence fluid infiltration of the perivenous stroma for tumescent analgesia and protection against thermal injury to the nearby structures. We describe an alternative technique using cold tumescence fluid infiltration, which is equally effective as, but safer than, room temperature tumescence fluid infiltration, and which yields better visual analog scores.

Film compression bandage

Phlebologie ◽  
2015 ◽  
Vol 44 (05) ◽  
pp. 249-255 ◽  
Author(s):  
J. C. Ragg
Keyword(s):  
Adhesive Bond ◽  
Patient Comfort ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Skin Reactions ◽  
Inflammatory Reactions ◽  
Elastic Film ◽  
Group A ◽  
Group B

SummaryPurpose: Textile compression stockings or bandages are limited in comfort; they do not allow uninterrupted wearing. A novel elastic film bandage was evaluated regarding practicability, patient comfort and effect on vein regression. Main endpoint was the frequency of symptomatic inflammatory reactions.Methods: In a comparative pilot study, a compression film bandage (CFB, investigational) comprising an elastic, self-adhesive breathable polymer film of d <20 µm was continuously worn for 14 d after foam sclero-therapy. Inclusion: 62 patients (26–68 y.) frequently doing sports and taking daily showers, 90 legs with superficial varicosities, 5–12 mm ø (MW: 7.3 mm), randomized to A) CFB + medical compression stocking (MCS), B) MCS alone, C) CFB alone. Follow-up examinations including ultrasound and photography were performed after 2, 4 and 8 weeks.Results: Continuous wearing time of 14 days was completed in 57/60 cases with CFB (95.0 %, A+C), while 3/60 (5.0 %) finished wearing after 8–10 d. There were no adverse skin reactions except minor irritations at the upper edge (n = 2). Vein diameters were reduced within 14 days by 29–54 % (mean: 43.5 %) in group A, 16–44% (mean: 39.1 %) in group B, and 24–50 % (mean: 37.3 %) in group C. Symptomatic inflammation, indu-ration or discolouration was observed within 28 days in 5/60 cases (8.3 %) when using CFB (A, C) versus 19/30 (63.3%) related to stocking compression (B). Comfort was rated by the patients 6.6 (A), 4.3 (B) and 9.2 (C) on a 10 degree scale. This difference was statistically highly significant (p <0.01).Conclusions: The film bandage is an effective and safe compression modality. For superficial varicosities the adhesive bond to the skin seems to be relevant additional to the elastic properties. The device significantly improves vein regression of foam-treated superficial varicosities when combined with compression stockings or even as stand-alone modality. Continuous wearing for two weeks is well tolerated. The bandage may also offer an alternative for patients not tolerating textile compression media, or during summer.

scholarly journals COMPARISON OF EFFICACY OF INJECTABLE STEROIDS VERSUS CONSERVATIVE MANAGEMENT FOR DE QUERVAINS’S TENOSYNOVITIS

2021 ◽  
Vol 12 (3) ◽  
pp. 217-221
Author(s):  
Nasim Ilyas ◽  
Fouzia Hanif ◽  
Rajesh Kumar Panjwani ◽  
Sheikh Kashif Rahim ◽  
Asma Abdul Qadeer ◽  
...  
Keyword(s):  
Conservative Management ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Post Intervention ◽  
De Quervain’S Tenosynovitis ◽  
Management Group ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

BACKGROUND & OBJECTIVE: De Quervain's tenosynovitis is tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons, occurs due to chronic overuse of the wrist and hand. To compare effectiveness of steroid injection with conservative management of De Quervains’s tenosynovitis. METHODOLOGY: Randomized prospective study was conducted at the various private orthopedic clinic across Rawalpindi district, along with collaboration of community medicine department, Rawal Institute of health sciences, Islamabad. The study population was divided into two groups, i.e., group A and group B. Group A was given inj. corticosteroid and group B was given conservative management. The severity of pain (Visual analogue scale) and Finkelstein test were recorded on baseline and after 3 weeks follow up. RESULTS: Our study included 96 diagnosed cases of de Quervains tenosynovitis on a positive Finkelstein test; 48 were given corticosteroid injection and 48 were conservatively treated. The mean age in corticosteroid’s injection group was 34.76+6.95 years whereas the mean age in conservative management group was 31.7+8.91 years. Post-intervention 13, 29 patients had a positive Finkelstein test in corticosteroid and conservative groups respectively. Although the difference in pre intervention pain score between the two groups was not statistically significant but significantly lesser pain scores in the corticosteroid group; (p= 0.00). CONCLUSION: Steroid injection produced better results in terms of relief in pain and negative Finkelstein test as compared to conservative treatment.

Effects of eccentric compression by a crossed-tape technique after endovenous laser ablation of the great saphenous vein: a randomized study

2009 ◽  
Vol 24 (4) ◽  
pp. 151-156 ◽  
Author(s):  
M Lugli ◽  
A Cogo ◽  
S Guerzoni ◽  
A Petti ◽  
O Maleti
Keyword(s):  
Laser Ablation ◽  
Postoperative Pain ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Randomized Study ◽  
Endovenous Laser Ablation ◽  
Eccentric Compression ◽  
Experienced Pain ◽  
Group A ◽  
Group B

Objectives To evaluate the effect of eccentric compression applied by a new crossed-tape technique on procedure-related pain occurrence after endovenous laser ablation (ELA) of the great saphenous vein (GSV). Methods From April 2005 to June 2006, 200 consecutive ELA procedures were randomized to receive (group A: 100) or not (group B: 100) an eccentric compression applied in the medial aspect of the thigh. Patients were scheduled for a seven-day examination to assess the level of pain experienced. Pain intensity was measured using a visual analogue scale giving a numerical grade from 0 (no pain) to 10 (worst pain ever). Results The intensity of postoperative pain was significantly reduced ( P < 0.001) in the eccentric compression group as compared with the non-compression one. Conclusions This technique of eccentric compression greatly reduces the intensity of postoperative pain after ELA of the GSV.

Compression with 23 mmHg or 35 mmHg stockings after saphenous catheter foam sclerotherapy and phlebectomy of varicose veins: A randomized controlled study

2018 ◽  
Vol 34 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Attilio Cavezzi ◽  
Giovanni Mosti ◽  
Roberto Colucci ◽  
Valentina Quinzi ◽  
Luca Bastiani ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Controlled Study ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Foam Sclerotherapy ◽  
Tissue Healing ◽  
Group A ◽  
Group B ◽  
Skin Healing ◽  
Single Blind

Objectives To compare two different medical compression stockings after varicose vein treatment. Patients and methods A randomized single-blind controlled study on two compression regimes after saphenous catheter foam sclerotherapy + phlebectomy was performed. After pads and 5 mmHg contention sock, 23 mmHg (group A, Struva 23®) or 35 mmHg (group B, Struva 35®) medical compression stocking was applied 24 h/day for seven days; subsequently 21–23 mmHg medical compression stocking in daytime. Symptoms, compliance, skin findings, and bioimpedance spectroscopy parameters were assessed. Results A total of 94 patients (48 and 49 limbs in groups A and B, respectively) were enrolled. Three (T3) and seven (T7) days post-operatively, most symptoms were significantly milder in group B, especially pain and heaviness at T7 and at day 40 (T40). Ambulation, medical compression stocking stability/tolerability and skin healing were significantly better in group B, with p = 0.046, 0.021/0.060, and 0.010, respectively, at T7. Bioimpedance parameters increased at T7 and decreased at T40 in both groups; leg reactance and limb L-Dex improved in group B at T7 and T40, respectively (p = 0.039 and 0.012). Conclusions Compression with 23 and 35 mmHg medical compression stocking after catheter foam sclerotherapy + phlebectomy was effective and well tolerated at immediate/short term. Compression with 35 mmHg medical compression stocking provided less adverse post-operative symptoms and better tissue healing. Bioimpedance results confirmed a slightly better edema improvement with 35 mmHg medical compression stocking.

A Comparative Study of Lignocaine, Pethidine, Ketamine and Placebo for Prevention of Pain on Propofol Injection

2021 ◽  
Vol 12 (6) ◽  
pp. 29-33
Author(s):  
Shagufta Naaz ◽  
Erum Ozair ◽  
Adil Asghar
Keyword(s):  
Saline Group ◽  
Good Choice ◽  
The Other ◽  
Double Blind ◽  
Pain Scores ◽  
Hepatic Diseases ◽  
Reduction Of Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Pain caused by propofol injection is a common occurrence. Aims and Objectives: The aim of this study was to compare and evaluate the efficacy of three drugs, lignocaine, pethidine and ketamine for prevention of pain during propofol injection. Materials and Methods: This double blind, placebo-controlled, parallel multi-arm study was done after written informed consent and ethics clearance. Hundred patients of ASA I and II, 18-65 years of age, and with body mass index 18-30 kg/m2 were included. Exclusion criteria were significant cardiovascular or hepatic diseases, renal insufficiency, and a history of allergy to the study drugs. Group A (Normal Saline), Group B (Ketamine 25 mg), Group C (Lignocaine 20 mg) and Group D (Pethidine 25 mg) were pre-treated with 2 ml of the study agents before propofol injection. The primary outcome was the incidence of pain with propofol injection and the secondary outcomes were the induction time, pain scores at various time intervals, the incidence of recall of pain after surgery, haemodynamic changes and adverse effects. Results: There were highly significant differences (p<0.001) in the incidences of pain during propofol injection in group A and the other three groups. The difference in incidence of pain was also significant between Group C and other groups. The differences in the pain scores (p<0.001) and recall of pain (p<0.05) between group A and the other three groups were significant. Conclusion: Lidocaine may be considered as a good choice for the purpose of reduction of pain during propofol injection.

Endovenous laser ablation of great saphenous veins using a 1470 nm diode laser and the radial fibre – follow-up after six months

2010 ◽  
Vol 26 (1) ◽  
pp. 35-39 ◽  
Author(s):  
F Pannier ◽  
E Rabe ◽  
J Rits ◽  
A Kadiss ◽  
U Maurins
Keyword(s):  
Laser Ablation ◽  
Diode Laser ◽  
Laser Energy ◽  
Varicose Veins ◽  
Compression Stockings ◽  
Efficient Treatment ◽  
Endovenous Laser Ablation ◽  
Saphenous Veins ◽  
Bare Fibre

Background Endovenous laser ablation (EVLA) is an efficient method to treat insufficient great saphenous veins (GSV) with high occlusion rates.1–5 Most studies used 810, 940 or 980 nm diode lasers and a bare fibre.1,2,6 Moderate postoperative pain and bruising are frequent findings.2,6 Laser systems with higher wavelengths like 1470 nm with a higher absorption in water show less pain and bruising after the procedure.7–9 A newly-developed fibre (radial fibre, Biolitec) emits the laser energy radially around the tip directly into the venous wall contrary to the bare fibre.9 The aim of this study was to demonstrate the outcome and side-effects after EVLA of GSV with a 1470 nm diode laser (Ceralas E, Biolitec) by using the radial fibre. Methods Non-randomized, prospective study including 50 unselected limbs of 50 patients with a duplex sonographically verified incompetent GSV. EVLA was performed with a 1470 nm diode laser (Ceralas E, Biolitec) and a radial fibre. In the same session all insufficient tributaries were treated by phlebectomy. Tumescent local anaesthesia with 0.05% lidocaine was applied perivenously. Laser treatment was carried out in a continuous mode with a power of 15 W. Compression stockings (30 mmHg) were applied for one month. Postinterventional checkups took place one, 10, 30 days and six months after the procedure. Results Three patients were lost to follow-up. The average linear endovenous energy density (LEED) was 90.8 J/cm vein (SD 35.3). At the six month follow-up all treated veins remained occluded and no new reflux in the treated segments occurred. No recurrent varicose veins had occurred so far. No severe complications such as deep venous thrombosis could be detected. In four patients at 30 days and three patients at six months local paresthesia occurred in the region of EVLA. Forty-four percent of patients did not have any pain after the treatment and 50% did not take any analgesic tablets at any time after the procedure. Postoperative ecchymoses in the track of the treated GSV was rare. In 80% of the limbs, no ecchymoses was observed after the treatment. Conclusion EVLA of GSV with a radially emitting laser fibre by using a 1470 nm diode laser is a safe and efficient treatment option.

scholarly journals Postoperative morbidity differences between proximal and distal knee saphenous harvesting in coronary artery bypass graft surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 131-135
Author(s):  
Ismail Selçuk ◽  
◽  
Nehir Selçuk ◽  
Bülent Barış Güven
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Wound Complications ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Group A ◽  
Group B ◽  
Level Group

Objectives. Coronary artery bypass grafting (CABG) is the most common procedure in cardiac surgery and the great saphenous vein (GSV) are the preferred conduits. The effects of saphenous vein incision (SVI) harvesting site choice on SVI wound complications, pretibial edema, and the need for compression stockings were evaluated retrospectively in patients undergoing CABG surgery. Materials and Methods. A total of 1900 patients operated for CABG between 2003 and 2021 in our clinic were included in this study, with GSV harvest performed at below-knee level (Group-A, n:841) and above-knee level (Group-B, n:1059). SVI was made 2 cm superior and 1 cm anterior to the medial malleolus in group-A; and 3 cm superior to medial epicondyle, extending to 3 cm inferior to the inguinal ligament in group-B. Examination for edema was made with 4-5 seconds of thumb pressure at the ankle level, then the depth of the pit was measured. Results. Ankle edema (Group-A n:132, Group-B n:25), the use of compression stockings (Group-A n:97, Group-B n:13), and paresthesia (Group-A n:51, Group-B n:10) were different between the two groups and the differences were statistically significant. However, prolonged wound healing (Group-A n:11, Group-B n:38), superficial wound infection (Group-A n:6, Group-B n:11), hematoma (Group-A n:4, Group-B n:9), and lymphorrhea (Group-A n:4, Group-B n:7) incidences were not statistically different between the two groups. Conclusions. Among patients with GSV extracted using the open conventional surgery technique, pretibial edema, paresthesia, and compression stocking use were observed less frequently in patients with preoperative doppler-ultrasonography evaluation and above-knee saphenous harvest.

The efficacy of diode laser removal of leukoplakias on the tongue and in lower buccal cavity compared to other buccal cavity locations. A two-year study

Open Medicine ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. 192-203
Author(s):  
Marek Vlk ◽  
Roman Smucler
Keyword(s):  
Laser Ablation ◽  
Diode Laser ◽  
Malignant Transformation ◽  
Buccal Cavity ◽  
Premalignant Lesions ◽  
Surgical Interventions ◽  
Increased Risk ◽  
Group A ◽  
Group B ◽  
Clearing Rate

AbstractIntroduction. Leukoplakias of the buccal cavity are premalignant lesions with a significant 0–20% potential for malignant transformation. In addition to active follow-up screening procedures, a number of surgical interventions are recommended for their removal. One of the preferred procedures is laser ablation with consecutive histopathology using one of the many types of lasers. The efficacy of such procedure with respect to the lesion location is, however, unclear. Many studies are contradictory. Some shows laser ablations as prevention of malignisation other see it as increased risk. Aim of this is to test treatment in different locations for two years. Material and method. An outpatient ablation by a 980mm diode laser of lesions on the tongue and in the lower buccal cavity (Group A) and lesions in other parts of the buccal cavity (Group B) were performed under local anaesthesia. In total, 76 lesions were treated in 66 patients. Recurrence after 1, 3, 6, 9, 12, and 24 months were followed up. Initially, all lesions were histopathologically tested. Concurrently, the subjective tolerance of the procedure was monitored, using a 1 (ideal) to 5 (worst) scale. Results. Clearing rate of lesions was of 84.6% for Group A and of 94.7% for Group B. In two patients (3% of Group A) malignant transformation occurred which was not observed in Group B. Patient toleration in various time intervals was always higher in Group B, but generally was very high in both groups. Conclusion. Malignant transformation of leukoplakias does occur even after laser ablation, and for this reason it is necessary to subject the patients to systematic follow-ups. It is significantly higher risk of recurrences and malign transformation in tongue and oral base. Laser ablation is a simple and well-tolerated procedure with high clearing rate.

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

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