Your Operation
Your varicose veins have
been removed with a special hook via a number of small ‘stab’ incisions.
These incisions will typically be about ¼ cm long, do not
require stitches and are usually dressed with ‘steristrip’ adhesive
tapes or left undressed.
Usually, you will also have had the cause of your varicose veins
dealt with: the long saphenous vein has been tied off (ligated)
via a skin crease incision in the groin (3–5 cm long) and
stripped out to around the knee, or the short saphenous vein ligated
through a similar incision behind the knee. These wounds are closed
with a dissolvable stitch running underneath the skin surface.
Your Recovery
You have probably had a general anaesthetic. Most
people recover from anaesthesia rapidly and are able to go home
on the same day or the morning after the operation. It is usual
to feel a little tired for a few days.
Compression
Before the operation you were
fitted with compression stockings. At the end of the operation,
bandaging was applied
to your leg – a cotton wool bandage, a crepe bandage or
pads and then a cohesive compression bandage. The stocking was
then rolled over the top. This ensures that bleeding, bruising
and swelling is kept to an absolute minimum. The bandages and
any pads should be removed after 48 hours – 2 days after
the operation. You can then bath or shower! You should wear a
compression stocking on the operated leg for one week ‘day
and night’ (taking it off to shower) and for a further
week during the day (taking it off at night). Obviously, if you
have had surgery to both legs they both require stockings. Some
people find it more comfortable to wear a stocking during the
day for another week or so, especially if they had severe varicose
veins or a lot of swelling prior to surgery.
Your Wounds
Your legs will be bruised following surgery.
This fades over a few weeks, to be replaced by scar tissue. Your
leg may then feel hard and bumpy, especially along the inside
of the thigh. This softens up over a few months. Any steristrips
covering the small stab wounds start to curl up after a few days
when they can be gently peeled off. The stab wounds feel hard
initially but are usually invisible after a few months. Applying
a moisturiser to the wounds may help them to soften and fade
more quickly. Your groin wound should be kept clean and should
fade with time. It is possible for the wound to appear swollen
for a few days. Occasionally, clear fluid (lymph) or even spots
of blood may leak from the wound for a few days. This is not
serious and should be controlled by an absorbent dressing. If,
however, you develop a painful, swollen, inflamed wound it is
probably infected and requires antibiotics from your GP. This
has no long-term consequences.
Pain
Varicose vein surgery performed
expertly, using minimally–invasive techniques is not generally
very painful. Any discomfort is invariably controlled with painkillers
that
will be prescribed according to your needs. A typical regimen
is five days of regular paracetamol, supplemented with an anti-inflammatory
painkiller such as ibuprofen or diclofenac for the first couple
of days. Occasionally patients may suffer from numbness, tingling
and strange sensations (paraesthesia) if nerves in the leg are
caught up in scar tissue. This is rarely severe or unpleasant
and usually disappears after a few months.
Mobility
There are no restrictions
on what you can do after surgery. You will be limited by your
own comfort. We advice
that for the first week you should try and spend as much time
as possible sitting with your legs elevated (preferably higher
than horizontal) and walking. This ensures that blood flows efficiently
in the veins and will reduce swelling, aching and the risk of
DVT. Try to walk for at least 5 minutes every hour. More than
that is fine. During the second week try to return to normal
activity and there are no restrictions after 2 weeks – if
it feels good, do it! You may notice some ankle swelling at the
end of the day. This improves as the scar tissue softens up over
a few months. If you do get swelling, continue to wear your stocking
during the day and elevate the leg when resting. If you get severe
calf swelling and pain after a few days there is a possibility
that you have suffered a DVT and should seek medical help. DVT
is very uncommon.
Activities
Most people are able to drive
within a week – start
when you feel safe and are able to perform an emergency stop
without discomfort. Return to work depends on your job and the
magnitude of your surgery. Up to 2 weeks off work is common after
varicose vein surgery, perhaps 3 weeks if we have operated on
both legs. You should be cautious about long car journeys for
a few weeks (wear the stockings and stop and stretch your legs
at least every 2 hours) and you should not fly for at least 6
weeks.
Follow up
We usually review you in outpatients about six
weeks after surgery. If you develop a problem before then, contact
your surgeon or hospital to advise you or expedite your outpatient
appointment.
Afterwards
Developing more varicose veins in the future
is possible, but difficult to prevent. We usually advise living
a normal and full life. Wear graduated compression stocking (Below-knee
Class I or II are normally adequate, available from pharmacies)
at times of particular venous stress such as flying or pregnancy.
Activities such as walking and swimming are good for your veins,
as is elevating the legs when resting. Being sedentary or overweight
is bad for veins!
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