Comparison of Modified Above-Knee and Conventional Surgery with the Stripping of the Great Saphenous Vein of Varicose Veins of the Lower Extremities: A Retrospective Study

Objective. To compare the clinical effects of modified above-knee and conventional surgery with the stripping of the great saphenous vein of varicose veins of the lower extremities. Methods. Clinical data of patients with a varicose vein of the lower extremity from May 2016 to May 2018 were collected. A retrospective study was conducted on the patients receiving modified above-knee and conventional surgery with the great saphenous vein stripping. The baseline characteristics and long-term follow-up data were compared between the groups. Results. There were no significant differences in baseline characteristics between the two groups ( P > 0.05 ). The surgeries were successfully performed by the same group of surgeons under local anesthesia and neuraxial anesthesia. The hospital stay, operation time, intraoperative blood loss, total length, and number of incisions in the above-knee group were comparable to those in the conventional surgery group ( P > 0.05 ). The incidence of saphenous nerve injury and subcutaneous hematoma in the above-knee group was lower than that in the conventional surgery group ( P < 0.05 ). There were no significant differences in recurrent varicose vein incidences ( P > 0.05 ). After surgery, the venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ-14) scores of both groups were higher than those before operation ( P < 0.05 ). There was no significant difference in VCSS score or CIVIQ-14 scores between the two groups postoperation ( P > 0.05 ). At 24 months after surgery, the above-knee group (71.8%) and conventional surgery group (73.2%) resulted in changes of at least two CEAP-C clinical classes lower than baseline, respectively. Conclusion. The modified above-knee technique can ensure clinical outcomes, reduce intraoperative blood loss and complication incidences, and shorten the operative time. This gives evidence that the modified above-knee technique is worthy of clinical application.

Knowledge Regarding Risk Factors and Preventive Measures of Varicose Vein among Intensive Care Unit Staff Nurses

Background: Varicose vein has disturbed humans since ancient days as a chronic disorder. According to the current statistics given by the Express health care, approximately 2.7 million people worldwide suffer with varicose veins. If left untreated and undiagnosed, varicose veins can end up with pooling of blood in the venous system and further complications. Aim and Objectives: Aim of the study was to assess the knowledge of staff nurses regarding risk factors and preventive measures of varicose vein. The study objectives were to assess the knowledge of staff nurses working in intensive care units regarding risk factors and preventive measures of varicose vein, to develop an evidence-based information booklet for staff nurses regarding prevention of varicose veins and to find out the association between the knowledge scores of staff nurses regarding risk factors and preventive measures of varicose vein with selected demographic variables. Materials and methods: A quantitative research approach with a non-experimental descriptive survey research design was used to select 60 staff nurses working in the ICUs using convenience sampling method. The data was collected using a structured knowledge questionnaire developed by the researchers. Data was analysed using descriptive and inferential statistics using SPSS. Results: The study results showed that 53% of the staff nurses had adequate knowledge scores regarding the risk factors and preventive measures of varicose veins whereas 30% had moderate knowledge, and 17 % had inadequate knowledge scores. Significant association was found between demographic variables such as age, experience and education of staff nurses with their knowledge scores. Conclusion: Approximately only half of the study participants had adequate knowledge regarding risk factors and preventive measures of varicose vein. Hence it is recommended that extensive educational sessions to be conducted for further enhancement of awareness of staff nurses related to prevention and management of varicose veins.

Possibilities of bioimpedance method of investigation of elderly patients with chronic heart failure

Introduction. Diagnostics of congestive events in chronic heart failure (CHF) in elderly people is increasingly relevant due to the general aging of the population, which determines the search for new research methods. The aim is to evaluate the diagnostic capabilities of bioimpedance method in determining the severity of congestion in elderly patients with CHF. Materials and methods. 86 elderly patients with CHF of different clinical stages were examined, 36.0% of them were burdened with varicose vein disease of the lower limbs. Total body water content was assessed by active impedance at 50 kHz, extracellular fluid content — at 5 kHz. Results. Active resistance at 50 kHz in patients with CHF II B was 473.92±29.39, with CHF II A - 569.24±58.97, with CHF I — 601.33±24.64 ohms, respectively, at 5 kHz — 555.52±27.44, 633.50±51.32 and 722.50±15.85 ohms respectively. No total and/or extracellular fluid retention was detected in CHF II A without lower limb varicosity, and in 10 (58.8%) patients — in cases of its presence. Retention of total and/or extracellular fluid was detected in 74.4% of CHF stage II B patients, and 48.3% of them had varicose vein disease of the lower limbs. Discussion. Patients with CHF stage II B have the highest amount of total and extracellular fluid in the body compared to patients with CHF stage II A and CHF stage I, but the method is insensitive for diagnosis of fluid retention in the small circle of the circulation and differential diagnosis of the genesis of edema in varicose vein disease of the lower limbs. Conclusion. Bioimpedance imaging can be used for additional diagnostics of CHF in elderly patients in order to estimate the amount of total/extracellular fluid in the body to build personalized treatment and prevention programs.