Postoperative care after varicose vein surgery: patient-based questionnaire

Abstract

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.

A randomised controlled trial comparing compression therapy after radiofrequency ablation for primary great saphenous vein incompetence

“…Previous reports describing 72 h of compressive therapy postprocedural were performed in patients undergoing GSV stripping and show no difference in postoperative pain, complications and return to work, compared to longer duration of compressive therapy. 2 Leg volume is an objective measurement performed three times by the same person. These three measurements were summed, and the average leg volume was calculated.…”

“…Previous reports describing 72 h of compressive therapy postprocedural were performed in patients undergoing GSV stripping and show no difference in postoperative pain, complications and return to work, compared to longer duration of compressive therapy. 2…”

“…Till date, there is no consensus regarding the optimum duration of postoperative compressive therapy after varicose vein surgery. 2,3 A recent meta-analysis of randomised controlled trials showed no benefit from compressive therapy longer than one week following varicose vein surgery, regarding postoperative pain, leg volume, incidence of complications and return to work. 4 Current postoperative therapy following endovenous GSV ablation remains controversial.…”

“…Patients frequently report that compressive stockings are uncomfortable, leading to low therapy compliance. 2 It is the authors’ experience that compression stockings withhold patients from rapid mobilisation resulting in prolonged recovery time. In addition, compression stockings may cause blisters.…”

A randomised controlled trial comparing compression therapy after stripping for primary great saphenous vein incompetence

“…The authors concluded that bleeding directly after stripping could take place within seven minutes, whereas after mobilisation, no bleedings were shown. 9 Furthermore, patients report that compressive stockings are uncomfortable, leading to low therapy compliance 10 and withhold them from rapid mobilisation resulting in prolonged recovery. In addition, compression stockings may cause blisters and patients avoid treatment in the summer.…”