Many patients with varicose veins are frightened by the operation to remove the veins: if the veins are removed or bandaged, how will the blood circulate in the vessels of the legs? In fact, only a tenth of the blood circulates through the veins located under the skin, the same ones that form unsightly varicose veins. Removal of the superficial veins does not create a noticeable additional load on the deep veins.
Recovery after surgery to remove varicose veins from the legs must be complex, its objective is to prevent complications of the disease, the appearance of relapses and, as soon as possible, return the patient to work and normal activities. The measures that form the recovery program after the operation depend on the degree of neglect of the disease, the nature of the operation, as well as the general condition of the patient and the characteristics of her body.
What operations are performed for varicose veins on the legs?
There are three main types of operations for varicose veins of the lower extremities: classic venectomy (phlebectomy), vein removal and ligation.
Classic venectomy (phlebectomy).In the course of such an intervention, a longitudinal skin incision is made on the leg, corresponding to the course of the varicose vein. The vessel is isolated, bandaged around the ankle and knee (if we are talking about the lower leg) or knee and groin (if the vein is removed from the thigh), the large branches of the vein are bandaged and they are cut after the incision is sutured. Phlebectomy is an outdated technology that is practically unused these days, as it has been replaced by newer, less traumatic, and more effective surgical methods.
Peel.More advanced and modern phlebectomy modification and less traumatic than the classic operation. The essence of the intervention is that small punctures are made in the area of the ankle and knee (or knee and groin), the vein is highlighted, tied, a special flexible wire probe is inserted into its lumen and with its help the the vein is drawn from under the skin. The scars after such an intervention are minimal.
Vein ligation.With such an intervention, the varicose vein is not completely removed, it is only tied at the base of the varicose veins, so the blood circulation in the vessel stops and the nodes collapse. This type of intervention is considered ineffective for large veins, but for small vessels it is more convenient than their complete removal. Also, ligation of the veins makes sense if the vessel is naturally very tortuous, has sharp bends, or is sharply narrowed, making it impossible to guide the probe through the entire vein.
What can be the consequences after vein removal?
Surgery to remove varicose veins is a fairly traumatic intervention that seriously disrupts the internal balance of the body. Therefore, you need to be prepared for a certain discomfort in the postoperative period: pain in the area of intervention; bruising at the site of the excised vein and at the suture sites on the skin; leg swelling at the site of the removed vein and sutures; moderate bleeding from the postoperative wound; general weakness, fever, nausea.
Why are there such consequences? After removing the leg veins in the tissues that previously surrounded the vessel, an inflammatory process inevitably occurs - this is a natural physiological reaction of the body to the intervention aimed at healing the damage. Any inflammatory process is accompanied by swelling and local pain, and general symptoms of malaise are possible: nausea, fever, weakness. They disappear a few days after the intervention. A slight bleeding from the postoperative wound should also not bother: when the vein is removed, small vessels rupture which then collapse and the blood flow stops. If the surgeon's recommendations are followed, the unpleasant phenomena will quickly disappear.
In some cases, after venectomy surgery on the legs, infection of the intervention area, suppuration, thromboembolism or accumulation of blood in the tied vein with the development of vascular inflammation is possible. But thanks to the modern possibilities of surgery and the perfection of surgical techniques, such complications are extremely rare.
How to spend the postoperative.
The postoperative period after phlebectomy on the legs lasts ten days: from the moment of the operation to the complete removal of the stitches. At this time, the operated limb needs special attention and care.
After the operation, the patient is subjected to compression of the lower extremities using compression stockings. Compression is an important condition for a good postoperative course, since it allows the saphenous veins to be squeezed, avoiding stagnation of blood in them and, consequently, the formation of blood clots. Compression also accelerates the healing of the small veins that remain after removal of the main venous trunk.
The places where the sutures are applied should not get wet. For hygienic purposes in the postoperative period, wet wipes or gauze moistened with water are used. The stitches are regularly treated with iodine and a sterile bandage or adhesive is applied to protect them from damage and contamination.
To reduce the swelling of the lower extremities, it is recommended to keep them elevated, on a pillow, a tissue roller up to 15 cm high. In case of severe pain after the operation, the doctor may prescribe painkillers to prevent purulent antibiotic complications.
What activities are recommended in the rehabilitation period?
The rehabilitation period begins immediately after the end of the postoperative period, that is, 10 days after the operation. The stitches have already been removed at this point, the postoperative punctures, if there are no complications, have healed. But the body's recovery processes continue. In order for recovery to occur as soon as possible, the doctor adjusts the patient's lifestyle. In the rehabilitation period, you need:
- take medications prescribed by a phlebologist;
- reasonable physical activity, exercise therapy;
- limb compression;
- work in moderate conditions, restriction of heavy physical work;
- nutritional correction;
- physiotherapy, massages.
Drug therapy in the postoperative period involves taking drugs that increase the tone of the venous walls, improve the rheological (fluidity) properties of the blood, and have an anti-edema effect. The drugs recommended in the rehabilitation period include drugs based on troxerutin, diosmin, preparations with vitamins C and PP, extracts of ginkgo biloba, horse chestnut. As anticoagulants, drugs are used, including: salicylic acid, hirudin, heparin.
Drugs are prescribed both in the form of general drugs (tablets, capsules for oral administration) and local agents (gels, ointments to apply directly to the skin of the lower extremities). Competent drug therapy in the rehabilitation period allows you to accelerate the restoration of microcirculation, and at the same time serves as an effective prevention of recurrence of the disease.
Moderate physical activity is necessary to stimulate blood circulation in the lower extremities, prevent blood stagnation, and form blood clots. As best measures to activate the patient, it is recommended to walk at a moderate pace, swimming, complex exercise therapy. Running is not recommended during the rehabilitation period.
In the rehabilitation period, compression on the legs is required. Lower extremity compression is necessary for all patients with varicose veins; helps prevent disease progression and development of complications. The phlebologist recommends the compression method and selects the size of the elastic underwear.
Moderate working conditions are necessary so that there is no recurrence of the pathology, its transition to the deep veins of the legs. Varicose veins are often the result of difficult working conditions, characteristic of professional activity. If work is associated with prolonged standing, it may be worth changing it, or at least regularly during the working day, to perform therapeutic exercises aimed at improving blood circulation in the legs. It is contraindicated to work in high temperature conditions associated with vibrations, carrying heavy loads.
Nutritional correction after leg vein removal surgery should be directed toward rationalization. You need a complete, healthy diet, rich in protein, fiber, vitamins and microelements. If you are overweight, you should reduce the caloric content of the diet, since obesity is one of the factors in the progression of varicose veins.
Physiotherapy techniques in the rehabilitation period accelerate recovery. The doctor recommends the physiotherapy program, wraps, electrophoresis, high frequency, magnetotherapy can be helpful. Massage during the rehabilitation period helps to effectively remove swelling.
Competent management of the postoperative period after the removal of the dilated veins in the legs, a responsible attitude to the doctor's recommendations will help to eliminate the natural discomforts that arise after the operation as soon as possible, prevent possible complications and accelerate the return of the patient to a full life.
How to prevent reoperation
You need to understand: varicose veins after the operation will not go away. You can remove the enlarged vein, but the tendency to dilate other vessels will remain. Therefore, after the operation, it is necessary to take measures to prevent further progression of varicose veins.
If the work involves a long session, it is recommended to take short walking breaks, to perform simple exercises. It is necessary to sit at the desk with your feet on a small hill, without crossing one leg over the other.
Drink more water and less coffee to stay hydrated. Eliminate fast food and carbonated drinks from your diet. You should eat as much as possible five times a day in small portions.
It is worth giving up high heels and tight clothing that tightens the veins. To prevent the progression of varicose veins, it will be useful to wear special compression stockings, which will be prescribed by a doctor.
You will also have to refuse to visit a bath or sauna. Due to the high temperature in the body, even more dilated veins may appear, cramps, muscle aches may begin. High air temperature can also lead to trophic ulcers.
It is also important to visit your phlebologist every six months. The specialist will be able to determine the progression of the disease in time and take the necessary measures in a timely manner.