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 in the legs? In fact, only a tenth of the blood circulates through the veins located under the skin - the same ones that make up unsightly varicose veins. Removing the superficial veins does not create a noticeable additional load on the deep veins.
The recovery after surgery to remove varicose veins in the legs must be complex, its objective is to prevent complications of the disease, the appearance of recurrences, and as soon as possible, the patient's return to work and normal activities. The measures that make up the postoperative recovery program depend on the degree of negligence of the disease, the nature of the operation, as well as the patient's general condition and the characteristics of his body.
What operations are performed for varicose veins in the legs
There are three main types of operations for varicose veins in the lower limbs: classic venectomy (phlebectomy), stripping and ligation of the vein.<2_img_blockxx>
Classic venectomy (phlebectomy).During this intervention, a longitudinal skin incision is made in 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 leg) or knee and groin (if the thigh vein is removed), the large branches of the vein are bandaged and cut, after which the incision is sutured. Phlebectomy is an outdated technology that is practically unused today, as it has been replaced by new, less traumatic and more effective surgical methods.
Pickling.More advanced and modern modification of phlebectomy and less traumatic than the classic operation. The essence of the intervention is that small punctures are made in the ankle and knee region (or knee and groin), the vein is detached, tied, a special flexible wire probe is inserted into its lumen and with its help the vein is pulled to outside the skin. Scarring after this intervention is minimal.
Vein ligation.With this intervention, the varicose vein is not completely removed, it is only tied at the base of the varicose veins, due to which the blood flow in the vessel stops and the nodules collapse. This type of intervention is considered ineffective for large veins, but for small vessels it is more convenient than its complete removal. In addition, ligating the veins makes sense if the vessel is naturally very tortuous, has sharp curves or sharp narrowing, which makes it impossible to conduct the probe along the entire length of the vein.
What can be the consequences after removing the veins
Surgery to remove varicose veins is a very traumatic intervention that seriously disturbs the body's internal balance. Therefore, you need to be prepared for some postoperative discomfort: pain at the intervention site; bruises at the removed vein site and at the skin suture sites; swelling of the leg 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 the removal of the leg veins from the tissues that previously surrounded the vessel, an inflammatory process inevitably occurs - it is a natural and physiological reaction of the body to the intervention aimed at healing the damage. Any inflammatory process is accompanied by local swelling and pain, and general symptoms of malaise are possible: nausea, fever, weakness. They disappear within a few days after the intervention. A slight bleeding from the post-operative wound shouldn't bother either: when the vein is removed, small vessels rupture, which then collapse, and blood flow stops. If the surgeon's recommendations are followed, unpleasant phenomena will quickly disappear.
In some cases, after venectomy surgery on the legs, infection of the area of intervention, suppuration, thromboembolism or accumulation of blood in the vein connected with the development of vascular inflammation is possible. But, thanks to the modern possibilities of surgery and the improvement of surgical techniques, such complications are extremely rare.<3_img_blockxx>
How to spend the post-operative period
The postoperative period of phlebectomy in the legs lasts ten days: from the moment of the operation itself until the complete removal of the stitches. At that moment, the operated limb needs special attention and care.
After the operation, the patient undergoes compression of the lower extremities with a compression stocking. Compression is an important condition for the smooth running of the postoperative period, as it allows compressing the saphenous veins, preventing blood stagnation in them and, consequently, the formation of blood clots. Compression also accelerates healing of small veins left after removal of the main venous trunk.
The places where the sutures are applied must not be wet. For post-operative hygiene purposes, wet wipes or gauze moistened with water are used. Stitches are regularly treated with iodine and a sterile bandage or adhesive is applied to protect them from damage and contamination.
To reduce swelling of the lower limbs, it is recommended to keep them elevated - on a pillow, roll fabric up to 15 cm in height. In case of severe postoperative pain, the doctor may prescribe painkillers to prevent purulent complications - antibiotics.
What activities are recommended in the rehabilitation period
The rehabilitation period starts 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 post-operative punctures, if there are no complications, are healed. But the body's recovery processes continue. In order for recovery to occur as quickly as possible, the doctor adjusts the patient's lifestyle. In the rehabilitation period, you need to:
- taking medication prescribed by a phlebologist;
- reasonable physical activity, exercise therapy;
- limb compression;
- working in economic conditions, restriction of heavy physical work;
- nutritional correction;
- physiotherapy, massage.
Postoperative drug therapy involves the use of drugs that increase the tone of the venous walls, improve the rheological properties (fluidity) 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, medications are used, which include: salicylic acid, hirudin, heparin.
Medications are prescribed in the form of general medications (tablets, capsules for oral administration) and local agents (gels, ointments for direct application to the skin of the lower extremities). Competent drug therapy in the rehabilitation period allows accelerating the restoration of microcirculation and, at the same time, acts as an effective prevention of disease recurrence.
Moderate physical activity is needed to stimulate blood circulation in the lower extremities, prevent blood stasis and form blood clots. As the best measures to activate the patient, walking at a moderate pace, swimming, and exercise therapy complexes are recommended. Running during the rehabilitation period is not recommended.
In the rehabilitation period, compression in the legs is necessary. Compression of the lower extremities is necessary for all patients suffering from varicose veins - it helps to prevent disease progression and the development of complications. The phlebologist recommends the compression method and selects the size of the elastic underwear.
Sparing 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 stay, it may be worth changing it, or at least regularly during the workday, perform therapeutic exercises to improve blood circulation in the legs. Working in high temperature conditions associated with vibration, carrying heavy loads is contraindicated.
Nutritional correction after leg vein removal surgery should be directed towards rationalization. A complete, healthy diet rich in protein, fiber, vitamins and trace elements is needed. If you are overweight, you should reduce the caloric content of your diet, as obesity is one of the factors in the progression of varicose veins.
Physical therapy techniques in the rehabilitation period speed up recovery. Physiotherapy program is recommended by the doctor, wraps, electrophoresis, high frequency, magnetotherapy may be helpful. Massage during the rehabilitation period helps to effectively eliminate swelling.
Competent management of the postoperative period after the removal of the dilated leg veins, a responsible attitude to the doctor's recommendations will help to eliminate the natural discomfort that occurs in the postoperative period as quickly as possible, prevent possible complications and speed up the patient's return to a full life.<4_img_blockxx>
How to prevent reoperation
You need to understand: varicose veins after the operation will not go away. You can remove the dilated vein, but the tendency to dilate other vessels will remain. Therefore, after the operation, it is necessary to take measures to prevent the 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 table 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 beverages from your diet. You need to eat as much as possible five times a day, in small portions.
It's worth giving up high-heeled shoes and tight clothes that pinch your veins. To prevent the progression of varicose veins, it will be helpful to wear special compression stockings, which will be prescribed by a doctor.
You will also have to refuse to go to a bath or sauna. With the high temperature of the body, veins may appear even more dilated, cramps, muscle pain. High air temperature can also cause trophic ulcers to appear.
It is also important to visit your phlebologist every six months. The specialist will be able to timely determine the progression of the disease and take the necessary measures in a timely manner.