About varicose vein surgery

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1 About varicose vein surgery Other formats If you need this information in another format such as audio tape or computer disk, Braille, large print, high contrast, British Sign Language or translated into another language, please telephone the Communications Department on What are varicose veins? Arteries carry blood away from the heart, and around the body. Veins carry blood back to the heart. Varicose veins are swollen veins on the surface of the leg. They usually start on the calf, but can be found right up to the groin. They are more obvious when you stand up. How do they develop? Valves in the veins keep the blood flowing one way towards the heart. When we stand upright, gravity puts pressure on the veins in the legs, and they have to work harder to pump blood back upwards to the heart. Varicose veins can be made worse by standing for long periods, being overweight and by pregnancy. For a number of different reasons these valves may not work properly allowing blood to leave the high pressure veins and enter the low pressure superficial veins. These veins respond by becoming tortuous or varicose. How varicose veins develop Healthy vein with healthy valves Varicose vein with weakened valves Leaflet number: 306 / Version number: 3 / Review date: Feb 12 1 of 5

2 Why is treatment needed? There are many reasons for treating varicose veins. Currently best practice indicates that the reasons for treatment are; Varicose eczema Bleeding Ulceration and/or Superficial thrombophlebitis (clotting in the veins) What treatments are available? Injection treatment (sclerotherapy) can be an effective treatment for small varicose veins. The varicose veins are injected with a substance which scars the inside of the vein and makes it collapse. For larger veins the only treatment is an operation to remove the veins. This works because the other veins deeper in the leg can take on the job of carrying the blood. What does surgery involve? Surgery is usually done under general anaesthetic, but a spinal anaesthetic is an option for some patients. This is when a local anaesthetic is given through the back to numb the nerves for a few hours from the waist down. The varicose vein operation involves tying off the source of any veins in which the valves have failed. This is done through small incisions. These are made either in the groin or behind the knee depending on which veins are diseased. If a large vein inside the leg is affected, the vessel is removed using a technique known as stripping. It is taken out of a small incision at one end of the vessel. For smaller veins, tiny incisions are made in the leg over the veins. Removing veins will not affect the circulation of blood in the leg because of the veins deeper in the leg. What problems can occur after varicose vein surgery? The long-term outcomes of varicose vein surgery are usually excellent. The scars fade to tiny white marks over the months. The veins, which have been removed at the operation, will never return, but sometimes other normal veins become varicose veins or very small new veins form. Some pain, hardness and redness down the line of the vein may be present for up to 4 weeks. Injection or further surgery can treat residual veins if needed. Wound infections can happen but are very uncommon. Areas of numbness or pins and needles near the incision sites can sometimes be felt, caused by nerves being stretched during the operation. These often recover, but sometimes permanent numbness can occur. About varicose vein surgery 2 of 5

3 Preparing for your operation Surgery often requires a short stay in hospital as a day case or if longer, no more than one night. You may come into hospital on the day of your operation or sometimes the day before. You should have nothing to eat for 6 hours before the operation and nothing to drink for 2-3 hours beforehand. Depending on the veins needing surgery, you may need a duplex scan before the operation. A duplex scan gives an image of the veins; this is an out patient procedure. If necessary, you will be informed of this by your surgeon or your surgeon s secretary. You will also be asked to attend a Pre-op Assessment Clinic. This provides the opportunity to identify and minimise any risks involved in you having surgery and anaesthesia. It also provides you with a more informal setting in which to talk about the operation and the recovery afterwards. Once you are in hospital your surgeon or a team member will visit you. If you are uncertain of anything or have any questions, please ask. The veins are marked with a pen before surgery. The anaesthetist will also see you before the operation. After the operation Going Home This will depend on how fit you are, who is at home with you and how comfortable you feel. Most patients can go home the day after surgery. You should be comfortable enough to walk around normally. You may feel more tired than usual for the first few days due to the anaesthetic. Pain You will have some pain, hardness and redness down the line of the vein for up to 4 weeks. The bruising and soreness will slowly fade. Discomfort is not usually severe and can be treated with simple painkillers. Sometimes tender lumps can be felt in the legs where the veins have been removed. These are small bruises and gradually disappear over a period of weeks. Dressings and Stitches You will have bandages applied to your leg at the conclusion of the operation. These gently compress the leg, reduce swelling and discourage bruising. The bandages may be removed before you leave hospital or they may need to stay in place for 7-10 days. Once the bandages are off you will need to wear firm compression stockings for up to 6 weeks. You may have stitches or clips which need to come out after 7-10 days. Your practice nurse or a district nurse will do this. Some surgeons use stitches that dissolve. The nurses will tell you about wound care before you go home. Washing You may remove your compression stockings to bath/shower and put them back on afterwards. If you go home with bandages on, you will need to avoid showering/bathing and strip wash instead, until the bandages are removed. About varicose vein surgery 3 of 5

4 Mobility and Exercise After surgical treatment for varicose veins, it is best to sit with your feet elevated and to avoid standing still for long periods. Walking is very beneficial and will help your leg heal. Try walking 3 miles a day, or for about 20 minutes 3 times a day if possible. Driving You can drive as soon as you can make an emergency stop without discomfort in the wound, usually about 7-10 days after the operation. Sex You can restart sexual relations when the wound is comfortable enough. Work Depending on the nature of your job, most people are able to return to work within 1-2 weeks. What should I do if there is a problem? If you have persistent pain, persistent bleeding, fever or an inflamed or discharging wound please contact your family doctor. If your GP cannot help, please feel free to contact your consultant s secretary at the NDDH ( ). Further information If you are worried or unclear about any aspect of your varicose vein surgery, please ask the doctors or nurses. Remember we are here to help. The Pre-op Assessment Team are also here to talk to a 24hour answer phone service is available on Other useful contacts British Vascular Foundation Fides House 10 Chertsey Road Woking SURREY GU21 5AB Tel: Web: (Now at Best time to telephone: 9.30am pm, Monday - Friday. Answer phone at all other times. About varicose vein surgery 4 of 5

5 PALS The Patient Advice and Liaison Service (PALS) ensures that the NHS listens to patients, relatives, carers and friends, answers questions and resolves concerns as quickly as possible. If you have a query or concern, please visit them in the Information Centre on Level 2 at North Devon District Hospital or contact them on Have your say Northern Devon Healthcare NHS Trust aims to provide high quality services. However, please tell us when something could be improved. If you have a comment or compliment about a service or treatment, please raise your comments with a member of the ward staff in the first instance. Please also take the time to complete a comment card Tell us what you think, so we can make improvements. If you would like to make a formal complaint, please contact the Customer Relations Manager on or put your concerns in writing to the Chief Executive, Northern Devon Healthcare Trust, Raleigh Park, Barnstaple, EX31 4JB. Was this leaflet useful? If you have any suggestions to improve this leaflet, please contact the Communications Department on North Devon District Hospital Raleigh Park, Barnstaple Devon EX31 4JB Tel Northern Devon Healthcare NHS Trust About varicose vein surgery 5 of 5

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