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    Varicose vein surgery

    What is a varicose vein?

    Varicose veins are veins that have become abnormally thick, full of twists and turns, or enlarged. The term commonly refers to the veins in the legs and thighs, although varicose veins can occur elsewhere.

    What causes varicose veins?

    The consensus is that defective/damaged valves within the veins are the cause. Valves prevent backward flow of blood within the vein, they keep blood in the vein moving toward the heart.
    Many factors can increase your likelihood of developing varicose veins:

    • Gender: women are more likely to be affected by varicose veins than men, because female hormones tend to relax the walls of veins, making the valves more prone to leaking.
    • Genetics: varicose veins may be partly caused by your genes, your risk of developing them is increased if a close family member has the condition.
    • Age: As time passes, veins start to lose their elasticity and the valves inside them stop working as well.
    • Being overweight: overweight puts extra pressure on your veins, which means they have to work harder to send the blood back to your heart. This can put increased pressure on the valves, making them more prone to leaking
    • Occupation.  jobs that require long periods of standing may increase your risk of getting varicose veins.
    • Being pregnant: added pressure on the veins in the legs by the weight of the growing uterus and the relaxation effects of the hormones estrogen and progesterone on the vein walls contribute to the development of varicose veins during pregnancy.

    What are the symptoms of varicose veins?

    • Appearance of large veins under the surface of your skin.
    • Mild swelling of your ankles and feet, especially in the evening.
    • Painful, achy, or “heavy” legs.
    • Cramps may develop especially when making a sudden move as standing up.
    • Minor injuries to the area may bleed more than normal or take a long time to heal.
    • Itchy legs, especially on the lower leg and ankle. Sometimes this symptom is incorrectly diagnosed as dry skin.
    • Discolored, brownish-yellow shiny skin near the affected veins.
    • Whitened, irregular scar-like patches can appear at the ankles, known as atrophie blanche vasculitis.

    Why is a varicose vein surgery needed?

    Surgical removal or obliteration of varicose veins is often for cosmetic reasons. Non-cosmetic indications include symptomatic varicosities (eg. pain, fatigability, heaviness, recurrent superficial thrombophlebitis, bleeding), or for the treatment of venous hypertension after skin or subcutaneous tissue changes, such as lipodermatosclerosis, atrophie blanche, ulceration, or hyperpigmentation have developed. Most varicose veins are reasonably benign, but severe varicosities can lead to major complications, due to the poor circulation through the affected limb.
    It is important to know, that varicose veins can lead to dermatitis, an itchy rash. If you have varicose veins in your legs, dermatitis may affect your lower leg or ankle. Dermatitis can cause bleeding or skin ulcers (sores) if the skin is scratched or irritated. Varicose veins also can lead to a condition called superficial thrombophlebitis, which is a blood clot in a vein. Superficial thrombophlebitis means that the blood clot occurs in a vein close to the surface of the skin. This type of blood clot may cause pain and other problems in the affected area.

    How does the procedure work?

    The removal of varicose veins does not affect blood flow because other veins and especially the deep veins take over this job. During varicose vein stripping, your surgeon will make several small cuts, or incisions, near the top and bottom of your damaged vein. One incision will be in your groin. The other will be farther down your leg, either in your calf or ankle. They will then thread a thin, flexible plastic wire into the vein through the groin incision. The wire will be tied to the vein and pulled out through the cut in the lower leg. Your surgeon will then close the cuts with stitches and place bandages and compression stockings on your legs.

    What are the benefits and risks of the operation?

    The aims of surgery are to normalize the pressure in the skin veins. This will prevent existing varicose veins from enlarging further, and will prevent new varicose veins from growing.  Fortunately, this treatment usually doesn’t mean a hospital stay or a long, uncomfortable recovery. Thanks to less invasive procedures, varicose veins can generally be treated on an outpatient basis, however, those having more complex surgery are recommended to stay at Medicover Hospital overnight.

    Varicose vein stripping is a safe, low-risk surgical procedure. However, there are always risks associated with surgeries, including an allergic reaction to anesthesia, infection at the incision sites, heavy bleeding, development of blood clots, eventual bruising or scarring.

    Am I a good candidate for varicose vein surgery?

    If you don’t respond to self-care or compression stockings, or if your condition is more severe, your doctor may suggest varicose vein surgery. However, those patients who cannot remain active enough to reduce the risk of postoperative deep vein thrombosis should not undergo surgery.
    Surgery during pregnancy is contraindicated because many varicose veins of pregnancy spontaneously regress after delivery. Varicose vein stripping usually isn’t recommended for people with poor leg circulation, skin infections, blood-clotting issues or for those who are very overweight.

    How should I prepare for the surgery?

    Before varicose vein surgery, there are a number of tests that need to be done according to your surgeon’s instructions. You should bring with you all the medications that you are currently taking. You will be admitted to your bed by one of the nurses who will also complete your nursing record. The surgeon who will be performing your operation will mark up your veins with a waterproof pen, agreeing with you, which veins will be removed.

    What shall I do after the surgery?

    Your doctor may prescribe pain medications and also advices you to stay off of your feet as much as possible for the first three to four days after surgery. You may be able to remove the bandages after four days have passed. During recovery, it’s important to keep your legs elevated when you’re sitting. You can prop up your legs with pillows. By the fourth week, you can probably return to your normal activities.

    Why is aftercare important after varicose vein operation?

    It usually takes two to four weeks to recover from varicose vein stripping. However, your recovery time will depend on how many veins were stripped and where they were located. Your surgeon will give you specific instructions you need to follow after the surgery until your incision heals adequately.

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