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 in the subcutaneous veins, the very ones that form the unsightly varicose veins. Removal of superficial veins does not create a significant additional load on the deep veins.
Recovery after surgery to remove varicose veins on the legs should be complex, its goal 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 his body.
What operations are performed for varicose veins in the legs
There are three main types of surgery for varicose veins of the lower limbs: classic venectomy (phlebectomy), stripping, and venous ligation.
Classic venectomy (phlebectomy).During this operation, 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 it is the lower leg) or knee and groin (if the vein on the thigh is removed), the large branches of the vein are bandaged and cut, after which incision is sutured. Phlebectomy is an outdated technology that is practically not used today, as it has been replaced by new, less traumatic and more effective surgical methods.
Striptease.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 area (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 pulled out from under the skin. The scars after such an intervention are minimal.
Venous ligation.With such an intervention, the varicose vein is not completely removed, it is only tied to the base of the varicose veins, as a result of which the blood circulation in the vessel stops and the nodes collapse. This type of surgery is considered ineffective for large veins, but for small vessels it is more appropriate than their complete removal. In addition, vein ligation makes sense if the vessel is naturally very tortuous, has sharp bends or sharp constrictions, which makes it impossible to conduct the probe the full length of the vein.
What can be the consequences after removing the veins
Surgery to remove varicose veins is a rather traumatic surgery that seriously disrupts the internal balance of the body. Therefore, it is necessary to be prepared for some discomfort in the postoperative period: pain in the intervention area; hematomas at the site of the removed vein and at the suture sites on the skin; swelling of the leg at the site of the removed vein and sutures; moderate postoperative wound bleeding; 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 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 in a few days after surgery. Even a slight bleeding from the postoperative wound should not bother: when the vein is removed, the 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 leg venectomy surgery, infection of the surgery area, suppuration, thromboembolism or blood accumulation in the ligated 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 period
The postoperative period after leg phlebectomy lasts ten days: from the moment of the surgery itself to the complete removal of the stitches. At this time, the operated limb requires special attention and special care.
After the operation, the patient undergoes compression of the lower limbs using compression stockings. Compression is an important condition for the smooth course of the postoperative period, since it allows you to squeeze the saphenous veins, preventing blood stagnation in them and, consequently, the formation of blood clots. Compression also accelerates the healing of the small veins left after removal of the main venous trunk.
The points where the sutures are applied must not be 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 swelling of the lower limbs, it is recommended to keep them raised - on a pillow, fabric roller up to 15 cm high. In case of severe pain after the operation, the doctor may prescribe painkillers, to prevent purulent complications - antibiotics.
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 adapts the patient's lifestyle. In the rehabilitation period, it is necessary:
- taking medications prescribed by a phlebologist;
- reasonable physical activity, physical therapy;
- limb compression;
- work in frugal conditions, limitation of heavy physical work;
- nutritional correction;
- physiotherapy, massage.
Drug therapy in the postoperative period involves taking drugs that increase the tone of the venous walls, improve the rheological properties (fluidity) of the blood and have an anti-edema effect. 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, which include: salicylic acid, hirudin, heparin.
Drugs are prescribed both in the form of general drugs (tablets, capsules for oral administration) and local agents (gels, ointments for application 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 relapses of the disease.
Moderate physical activity is required to stimulate blood circulation in the lower limbs, prevent blood stagnation and form blood clots. As the best measures to activate the patient, walking at a moderate pace, swimming, physical therapy complexes are recommended. It is not recommended to run during the rehabilitation period.
In the rehabilitation period, compression on the legs is required. Compression of the lower limbs is necessary for all patients suffering from varicose veins: it helps prevent the progression of the disease and the development of complications. The phlebologist recommends the compression method and selects the size of the elastic underwear.
Thrifty 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 the work is associated with a prolonged position, it may be worth changing it, or at least regularly during the working day, performing therapeutic exercises aimed at improving blood circulation in the legs. Working in high temperature conditions associated with vibrations, carrying heavy loads is contraindicated.
Nutritional correction after leg vein removal surgery should be directed towards rationalization. You need a complete, healthy food, rich in proteins, fibers, vitamins and microelements. If you are overweight, you should reduce the calorie content of the diet, as obesity is one of the factors in the progression of varicose veins.
Physiotherapy techniques in the rehabilitation period accelerate recovery. The physiotherapy program is recommended by the doctor, bandages, electrophoresis, high frequency, magnetotherapy can be useful. Massage during the rehabilitation period helps to effectively eliminate swelling.
Competent management of the postoperative period after the removal of dilated veins in the legs, a responsible attitude to the doctor's recommendations will help eliminate the natural discomfort that occurs after the operation as soon as possible, prevent possible complications and accelerate the patient's return to a full life.
How to prevent reoperation
You need to understand: varicose veins after the operation will not disappear. 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 sitting, it is recommended to take short breaks for walking, 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 the diet. You need to eat as much as possible five times a day in small portions.
It is worth giving up high-heeled shoes and tight-fitting dresses that tighten 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. From the high temperature on the body, even more dilated veins may appear, cramps, muscle pains may begin. The high air temperature can also provoke the appearance of 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 over time and take the necessary measures in a timely manner.