Healthy legs. Beautiful legs. Information for patients. Artemed Fachklinik DIAGNOSIS AND THERAPY CENTRE FOR VEINS AND SKIN

Transcription

1 Healthy legs. Beautiful legs. Information for patients DIAGNOSIS AND THERAPY CENTRE FOR VEINS AND SKIN Artemed Fachklinik Prof. Dr. Dr. Salfeld GmbH & Co. KG

2 Artemed-Fachklinik in Bad Oeynhausen Your diagnosis and therapy centre for veins and skin Artemed-Fachklinik in Bad Oeynhausen was founded in 1990 and together with other vein centres in Hamburg and Munich forms the Artemed clinic group. The clinic is located centrally in Staatsbad Oeynhausen in the direct vicinity of the spa gardens. Under the management of Prof. Dr. med. Dr. rer. nat. Kurt Salfeld and his consultant doctors Artemed- Fachklinik Bad Oeynhausen has developed into an internationally recognised diagnosis and therapy centre for those suffering from vein and leg ailments. Today it is one of the largest specialist clinics for vein medicine. The clinic has 8 operating theatres, a diagnostics ward, a clinical laboratory, a library and scientific workplaces. We treat national health as well as private patients. Our consultant doctors are specialists in the field of vein medicine. Our large team of medical staff with our wide range of specialised fields also makes us highly competent to deal with complicated cases. We treat, for example, recurring varicose veins (recurrent varicosis), vein thrombosis, venous insufficiency ulcer and vein inflammations. With our excellent medical expertise, state-of-the-art methods and an environment to feel at home in, we offer the ideal conditions to ensure a speedy recovery the average length of stay at our clinic is only 3 5 days. Affiliated are also private outpatient clinics for conservative and operative dermatology/plastic surgery with a total of 3 operating theatres as well as a private outpatient clinic for conservative and operative proctology.

3 We ll heal your vein disease Around every seventh German suffers from a venous disease that needs treating. Even young people are affected; women three times more often than men. The main factor is an inborn weakness of the connective tissues. All that preventative measures can do is merely slow down the development of spider-burst veins, varicose veins and secondary complications. Once spider-burst veins or varicose veins have developed, they no longer disappear by themselves. In the long term the dynamics of the disease can lead to venous insufficiency ulcer, phlebitis or deep-vein thrombosis. A vein operation is the most sensible solution and in most cases the only long-term method to get rid of varicose veins. Thorough examinations are carried out before each therapy. These examinations are performed at the Artemed-Fachklinik exclusively free of pain with highly modern ultrasound devices. We use gentle operating techniques and a modern wound treatment. We make an individual tailor-made therapy for the patient and his/her disease. We are in a position to successfully treat patients of any age/weight, so-called high risk patients (e.g. patients with cardiovascular diseases) and patients with acute vein inflammations and after the course of deep-vein thrombosis. The name Artemed is our credo: the medical operation is to be carried out so professionally that it also does justice to aesthetic demands a largely scar-free and attractive leg. But the ambient of our clinics also follows the name Artemed. It is shaped by art, in particular painting. Because only when you as a patient feel good at our clinic will you also make a speedier recovery. And that s what we want for you, too!

4 Spectrum of the vein treatments Spider-burst vein varicosis Reticular varicosis Varicosis of the stem veins Recurrent varicosis Phlebitis Venous insufficiency ulcer (ulcus cruris) Deep vein thrombosis Post-thrombotic syndrome Diagnostics Examination is not stressful for the patient and is carried out on an outpatient basis by means of an ultrasound scan with: bi-directional Doppler ultrasonography with a frequency spectrum analysis high-resolution colour-coded duplex sonography venous occlusion-plethysmography A phlebography (X-ray examination) is only necessary in exceptional cases and will be arranged by us. Therapy conservative or operative medicinal sclerotherapy (obliteration) in the case of spider-burst vein varicosis mixed treatment (sclerotherapy & crochet technique) with reticular varicosis sclerotherapy with endovenous laser therapy vein stripping with stem varicosis (according to Babcock) operation almost exclusively with local anaesthetic (tumescence anaesthetic) modern wound suturing techniques for almost scar-free healing surgical hoses for as short a time as possible (4 6 weeks)

5 Spider-burst veins Spider-burst veins are enlarged veinlets in the top layer of skin. In general they are merely a cosmetic problem. The cause is considered to be an inherited disposition. Factors such as sunbathing, saunas, steam baths, being overweight, smoking, hormones or pregnancies have an intensifying effect. Phlebology Spider-burst veins are sclerosed on an outpatient basis. To do this a special substance (aethoxysklerol) is injected into the spiderburst veins, which causes their medicinal conglutination and subsequent disintegration. This procedure generally requires several sessions. The costs of sclerotherapy in cosmetic operations is not borne by the compulsory health insurance companies. Spider-burst veins before and after the therapy by means of sclerosis (sclerotherapy). Reticular varicose veins Reticular varicose veins are a reticular venectasia and not only a cosmetic problem. They can become infected and in cases of injury lead to effusions or bleeding. Reticular varicose veins are treated on an outpatient basis using the mixed method. After a local anaesthetic they are removed with a kind of crocheting needle after the spider-burst veins have been sclerosed.

6 Varicose veins The human leg has superficial and deep veins. The deep veins are responsible for the return transport of approx. 90 % of our blood, the superficial veins only transport approx. 10 %. If the superficial veins no longer function properly, varicose veins (varices) occur. The main cause of varicose veins is an inherited weakness of the connective tissues along with a lack of exercise, eating habits and hormonal influences. A vein operation is the most sensible method to remove varicose veins in the long term. We operate according to a modern and gentle method: after a clear cut in the groin or knee hollow the so-called stem veins are pulled out with a special probe. This operation technique leads to very good medical and cosmetic results. Also in cases of complex operations (such as, for example, recurrent varicose veins) we achieve excellent results thanks to our many years of experience. The operation is mostly performed with a local anaesthetic, the tumescent local anaesthetic commonly known from the field of plastic surgery. Modern wound suturing techniques enable a healing process that leaves hardly any visible scars. The patient can and should walk again directly after the operation. In order to achieve ideal results, surgical hoses must be worn 4 to 6 weeks after the operation. Varicose veins develop from top to bottom. If the upper venous valves are defective, the pressure grows on the veins below, which are in turn destroyed by this process.

7 Varicose vein operation: this is how we do it! After a thorough preliminary examination we have an in-depth talk with the patient to discuss the individual therapy in detail. Preparations The varicose veins discovered by touch and ultrasound examination are marked on the skin by means of a waterproof pen. After the leg has been shaved the necessary preparations are made on the operating table, meaning disinfecting, arranging the monitoring instruments, covering the operating field, as well as the local anaesthetic in tumescence anaesthesia. Since a local anaesthetic is given there will be no narcosis risks with all the commonly known complications, such as circulatory problems, sickness and headaches. And: the risk of a life-threatening vein thrombosis is more or less excluded. Different types of vein operation In the case of a big vein operation the surgeon does not only remove the no longer intact vessels between the groin and the medial malleolus. He inserts a probe into the varicose veins and explores the vessel from the ankle up to the groin. If a complete exploration of the whole vein is not successful (e.g. in the case of very thick or porous veins and excessive branching), it will be removed in several individual steps. Inosculating side branches or connecting veins from the deep vein system will have been ligated beforehand. In the case of a small vein operation (e.g. up to the hollow of the knee) the operation is carried out in the same way. Of course, this procedure is shorter in terms of time than with the»big«operation. The length of the scar in each case is only 3 mm. After the operation After the operation all lacerations are carefully sutured, protected by a wound bandage and dressed with a pressure bandage. In most cases the patient can get up from the operating table without needing any assistance and even start walking around after an hour. On the next day the operation area is checked when the bandage is being changed. It could be that some small corrections are needed. The bandage is checked daily. The patient will be discharged after 3 to 5 days and will not be able to work for around 10 to 14 days. The wound stitches will be painlessly removed by your GP or in the clinic.

8 Procedure after the operation How long do the surgical hoses have to be worn? In most cases it is sufficient to wear the surgical hoses during the day for around three to four weeks (in exceptional cases up to six weeks). When can I do sport again? Depending on your age and physical condition most people can take up sporting activities again very soon after the operation. If you haven t done sport up to now it makes sense to take it up because it prevents new varicose veins from developing. Nevertheless, which kinds of sports are problematic? Due to the frequent abrupt stopping movement, tennis and squash should be avoided for about two months. What about visits to the sauna and solarium? Sweating impairs the wound healing. Therefore, visits to the sauna and solarium are not recommendable in the first few weeks. Can I take baths straight away? Taking baths and showers is only allowed after the healing process is complete due to the danger of infection.

9 Keyword Tumescence anaesthetic Whilst a conventional regional anaesthetic is normally used during a varicose vein operation with all its disadvantages, at the Artemed clinics we use a revolutionary method for this special field: the tumescence anaesthetic. This type of local anaesthetisation is regularly used in cosmetic surgery. We have now also introduced this method in varicose vein surgery after scientific preliminary tests were carried out and have been working with it for over 10 years, thereby achieving very good results. It offers excellent anaesthetisation even with complex operations and enables an operation to be performed practically without any blood. It is therefore also suitable in the case of risk and high-risk patients. Painkillers are mostly not needed after the operation. Info Varicose vein operation in summer? Absolutely YES! There are still some patients and referring doctors who have some reservations about having varicose vein operations in summer. However, neither from a medical nor an aestheticcosmetic point of view there is anyhing to be said against this. The healing phase is short. You can take a bath again after only a few weeks and even sunlight causes no damage. A varicose vein operation does not have to be performed immediately and can be planned to be carried out at a time that suits you best. We ll gladly arrange an operation date for you that is convenient for you taking into account your clinical picture. Outlook Laser therapy Endovenous laser therapy is an innovation which is increasingly being used as a sclerosing procedure in phlebology. This method can only be used with young, aesthetic-cosmetic oriented patients with a simple and non pre-treated varicosis. In order to prevent complications such as thrombosis, laser treatment on the stem veins will only be carried out if the diseased vein openings in the deep vein system have already been operatively divided (crossectomy). The crossectomy is not problematic with this patient group and is not a stress factor.

10 Preventative measures against varicose veins and spider-burst veins Regular physical activity such as hiking, cycling, jogging, using the stairs, gymnastics, swimming and dancing. We have developed a special form of vein gymnastics at the Artemed-Fachklinik Bad Oeynhausen: TanzVenenGymnastik (DanceVeinGymnastics). More information on this on the next page. Balance out sitting activities by moving about a lot and doing sport. In order to strengthen the muscle pump in the legs move your feet up and down as often as possible. Reduce weight it doesn t only put a strain on your heart and arteries but also on your veins! Become more aware of your veins by eating a healthy, high-fibre diet. Take the strain off your legs by frequently putting them up. Raise the foot part of the bed up at night. Reduce smoking. Even better: give up smoking! Don t wear shoes that are too tight, likewise no trousers, stockings or socks that are too tight. Avoid excessive heat. It is favourable to shower your legs using cold water daily starting from your feet and working upwards. These recommendations are also valid after a successful vein operation because varicose veins can, unfortunately, develop again.

11 TanzVenenGymnastik (DanceVeinGymnastics) Classic vein gymnastics are unfortunately frequently continued by the patients for only a short period after the stay in the clinic because these exercises are seen as boring, monotonous and no fun. However, since targeted movement is important to prevent continuing vein diseases we have, in cooperation with a physiotherapist and a choreographer, developed an entertaining form: the TanzVenenGymnastik (DanceVeinGymnastics). Vein gymnastics exercises are in principle always a focussed activation of the leg muscles. They can also be done in an easygoing way without a fixed sequence of movements and being accompanied by music. We are presuming that each person is musically and rhythmically minded and that his/her urge to be active can be prompted by music. Depending on the patient s personal ability, suitable music is selected, for example standard or Latin American rhythms. With short choreographic sequences danced to entertaining music it is fun to exercise. The developed movement units are ideally suited to effectively promote the flow of blood through the veins and to direct the breathing techniques accordingly. The simplicity of the exercises leads to quick success. The sequence of movements is promoted, the thrombosis risk is reduced, breathing, blood circulation as well as all muscle groups are stimulated. In this way the whole bodily well-being is positively influenced, the patient feels more relaxed. Even during the healing phase in the clinic we offer introductory courses for our patients. After the proper initial exercises of Tanz- VenenGymnastik have been carried out these can be easily continued at home. To make this easier we have compiled a DVD with a demonstration of TanzVenenGymnastik, which can be purchased from us for a small fee Info by dialling tel: +49-(0) We hope this method will also inspire our patients to become more active in the long term.

12 Dermatology Private outpatient clinic for conservative and operative dermatology and plastic surgery In our private outpatient clinic for conservative dermatology (incl. allergology and environmental medicine) we treat the whole spectrum of skin diseases, mucous membrane diseases as well as hair and nail diseases. Furthermore, we perform a detailed diagnostic investigation and therapy of allergies. In the framework of operative dermatology Artemed- Fachklinik offers expertise and an environment for all dermatological operations that go beyond the scope of outpatient practice and make an inpatient stay in hospital necessary. Skin cancer We offer regular skin cancer precautions with a computeraided examination by means of incident light microscope and clinical monitoring extending over years. In the case of malignant skin changes as well as their preliminary stages we offer you an outpatient operative removal after giving you detailed consultation and taking into account all functional and aesthetic demands. For this purpose we have the complete spectrum of dermatological operation possibilities at our disposal. A subsequent histological examination of the removed tissue is performed as a matter of course.

13 Dermatology Hair consultation Too little (or structurally conspicuous) hair growth can cause a great deal of distress. An effective treatment for hair loss is possible but requires the assessment of a competent dermatologist. Therefore, at the beginning of each treatment there will be a careful examination incl. blood level determinations as well as the performance of a painless hair analysis (photo trichogram). It enables a speedy and absolutely reliable measurement of hair growth, hair loss and hair type and with this also a check of the treatment success. Dermatology Ulcus cruris In our private outpatient clinic we offer you an expert therapy of venous insufficiency ulcer (ulcus cruris), an open skin ulcer on the legs which normally arises as a secondary complication of untreated varicose veins. The ulcus therapy takes place in accordance with the principles of modern wound treatment.

14 Dermatology Liposuction Medical liposuction does not serve the purpose of weight reduction but shapes the form and silhouette of certain body regions. The classic problem zones here are belly, legs and bottom. For example riding breeches on the upper thighs or other unattractive fat pads give many women and also men cause to think about having liposuction. The operations take place either exclusively under a local anaesthetic or a local anaesthetic in combination with a light anaesthesia. By using the finest granules we achieve a smooth removal of fat without lumps and dents being formed and consequently an ideal cosmetic result. We are at your disposal for a detailed counselling interview and will work out an individual therapy plan to style your body exactly to your requirements. Peeling Peeling is a dermatological-aesthetic treatment with glycol acid or trichlor acetic acid. It enables the correction of wrinkles acne scars pigmented moles flabby skin hormone blotches We ll be glad to explain the treatment options to you individually. Correcting wrinkles We offer the possibility to correct nasolabial wrinkles perioral wrinkles mouth corner wrinkles lip edge with poly-l-lactic acid (Sculptra TM ) Lactic acid is injected under the wrinkle, which produces an increase in volume. In general two treatments are necessary at intervals of 6 8 weeks. We ll be glad to advise you in detail in a personal meeting.

15 Proctology Outpatient clinic for conservative and operative proctology In our outpatient clinic for conservative and operative proctology (rectal diseases) after a detailed examination as well as an in-depth consultation we develop a treatment plan specific to the case from the conservative and operative methods available to us. Spectrum of the proctologic treatments Haemorrhoids including anal prolapse Anal thromboses Anal fistula Fissures (mucous membrane tears) New formations in the rectum and anal region, such as polyps, genital warts and anal folds Sphincter stenosis (sphincter muscle constriction) Periproctitis abscesses Haemorrhoids Haemorrhoids are really only vascular pads at the end of the rectum that everybody has. Only when this pad increases in size and causes discomfort do we speak about haemorrhoids as a clinical picture. The causes are increased pressure in the abdominal cavity, hard defecation, diarrhoea, intense pressing with bowel movement as well as laxative abuse. This causes an increase in size of the regular vascular pads which shift outwards. In the case of less serious diseases treatment with conservative medicines can be used. More serious stadiums require an operation. Besides the conventional operation procedure, such as cutting out the haemorrhoids, we offer modern, innovative alternatives such as, e.g. the stapler haemorrhoidectomy according to Longo or the Doppler sonographically steered haemorrhoidal arterial ligature. Both procedures offer considerable advantages: less pain, a shorter treatment period and being able to return to work quickly. Proctology

16 How to find us in Bad Oeynhausen v A30 Osnabrück Railway station north Mindener Straße A2 Dortmund/Hanover w B61 Minden w Spa gardens Portastraße Steinstraße Railway station south Weserstraße A2 Dortmund/Hanover w Artemed-Fachklinik Prof. Dr. Dr. Salfeld GmbH & Co. KG Portastraße Bad Oeynhausen Germany Tel: +49-(0) Fax: +49-(0) info-bo@artemed.de By car Motorway A2 Dortmund Hanover, exit motorway junction Bad Oeynhausen. From direction of Osnabrück via the B61. By train Route 200 Hanover Bad Oeynhausen Hamm Route 265 Braunschweig Hameln Bad Oeynhausen Löhne DIAGNOSIS AND THERAPY CENTRE FOR VEINS AND SKIN Artemed Fachklinik Prof. Dr. Dr. Salfeld GmbH & Co. KG