This minor operation is very well tolerated and takes place in the Doctor’s Rooms or in the Day Procedure Centre at Epworth Hawthorn.
This procedure consists of pulling out the varicose veins by making tiny incisions under local anaesthesia, leaving only marks that will be barely visible within a few months after the procedure. A small amount of local anaesthetic is used to numb the skin and area around the vein prior to their removal. The diseased or otherwise useless veins that have been pulled out cannot come back. You could, of course, develop other varicose veins independently from this treatment. These could also be removed. The procedure does not require that you interrupt your professional or domestic activities.
Bulging varices, or bulging varicose veins.
- Take a last bath or shower just before the procedure, since you won't be able to wet the limb on which the procedure will have taken place for 12-24 hours.
- DO NOT apply any type of moisturiser to your leg on the day of the procedure. DO NOT apply artificial tanning products one week prior and one-week post procedure.
- Please have a light breakfast or lunch prior to your procedure. Be well hydrated.
- Plan to wear shoes that are comfortable.
- Wear loose-fitting clothes.
- You can take your normal medications on the day of the procedure. Please notify Dr Campbell if you are taking any blood thinners such as Aspirin or Warfarin. Please bring a list of your current medications with you.
- IF you have sedation you WILL NOT be able to drive home. Please arrange for someone to drive you home. Less than 1% of patients require sedation, such as those who have a needle phobia or suffer from anxiety.
- If you have been professionally fitted and supplied with Grade II compression stockings, please bring these with you. If not, we will supply the stockings for a fee.
- Finally, make sure to be relaxed. Both the local anaesthesia and the procedure are very well tolerated.
- On the day of your procedure we recommend limited walking. It is best you rest and keep your feet elevated. The first day after your procedure you may go for a gentle 10-minute walk. From the second day after your procedure, active walking is required. It is the best and most natural way to prevent any complications, although they occur very rarely with this procedure. We recommend 20 minutes continuous walking daily for 1 week.
- Normal daily activities can commence 2 days following the procedure. Avoid long periods standing still. Strenuous activity is best avoided for 2-3 weeks. Do not fly for the first 2 weeks if the flight is more than 2 hours’ duration. Flying must be avoided for 4 weeks for flights more than 4 hours. General anaesthetics must be avoided for four weeks.
- The stockings should be worn continuously for the first 12-24 hours. The stockings may be removed the following morning for showering. Remove the padding taped over the dressings. Leave the steri-strips and waterproof dressings intact. Immediately re-apply the compression stocking(s) after your shower.
- Please wear the stockings from first thing in the morning until last thing at night for a total of 1-2 weeks depending on comfort.
- Post-procedural pain should not be severe and easily controlled with Panadol. This may be required for the first few days after the procedure.
- Avoid excessive sun exposure during the 2 weeks following the procedure.
- Bruising, local swelling and some tenderness are normal after treatment. This should be temporary. Aching in the leg may persist for up to 2 weeks.
- Tenderness associated with redness and warmth could indicate a local inflammatory response known as thrombophlebitis. Thrombophlebitis can occur in about 10% of patients. This is much more likely to occur if you do not wear your compression as recommended.
Thrombophlebitis is best treated with:
- Anti-inflammatory medication e.g. Nurofen, for 48hours.
- Ongoing compression and massage to the area.
- >Walking – half hour daily.
- Local massage twice per day with Hirudoid ointment.
Thrombophlebitis is often delayed and can occur between 2-4 weeks post procedure.
At your first review, any areas of thrombophlebitis may be treated with gentle expression of the thrombus via a small incision, usually via a needle prick. Infection is a rare occurrence, however, these symptoms could also be attributable to infection. Infection would generally be accompanied by systemic symptoms such as fever, loss of appetite and a general feeling of malaise and is best treated with antibiotics and drainage where necessary.
If bleeding appears on the stockings, please elevate your leg and apply local compression. Dr Campbell should be contacted via mobile phone 0412 509 504, at the Rooms on 9429 4111, or via the Epworth Hospital on 9426 6666.
Deep Venous Thrombosis
People with varicose veins are more susceptible to deep vein thrombosis. These blood clots can also form in the deep veins as a result of treatment of your varicose veins. This is extremely rare, occurring in less than 1% of patients, especially if patients follow instructions regarding stockings and walking. If you are unable to perform the required walking please discuss this with Dr Campbell prior to your procedure.
Deep venous thrombosis is more likely to occur in patients who have significant risk factors for thrombosis. This includes those who are smokers, overweight, have poor mobility, do not comply with post-procedure orders such as walking and compression, hormone intake (HRT and OCP) and those patients who have a past history of deep venous thrombosis or a thrombophilic disorder.
Your risk of DVT is doubled if you are taking any form of hormone treatment such as the oral contraceptive pill, hormone replacement therapy or a hormone containing IUD, such as Mirena. You may consider ceasing the hormone treatment one month prior to treatment and for one-month post treatment to reduce the elevated risk of DVT. However, the consequences of unplanned pregnancy and return of menopausal symptoms must be considered.
Injury to nerves
Veins and nerves lie close together. These nerves can be stretched when veins are removed. This can result in localised numbness that is usually temporary and recovers within 6 months. Rarely this loss of sensation is permanent, however, it should not affect function of the leg and diminishes with time. The risk of this is <1%. There is a rare possibility of a nerve injury affecting muscle strength especially when veins need to be removed near the upper outer part of the calf close to the fibula bone.
Only small incisions are made and the procedure involves very little trauma to tissues surrounding your varicose veins, hence, the risk of infection is very low. Infection rate is < 1%. This rate is increased if you are overweight, smoke or are diabetic.
A haematoma is a collection of blood within the soft tissues. This is usually prevented by compression. This may be felt as a firm lump with associated bruising and discomfort. Once formed, it would not be expected that it would continue to increase in size. It almost always dissolves over time.