Value of postoperative compression after mini-invasive surgical treatment of varicose veins

• Published in: Journal of vascular surgery. Venous and lymphatic disorders (New York, NY) Vol. 1; no. 4; pp. 385 - 391
• Main Authors: Pittaluga, Paul, MD, Chastanet, Sylvain, MD
• Format: Journal Article
• Language: English
• Published: United States 01.10.2013
• Subjects: Surgery
• ISSN: 2213-333X
• DOI: 10.1016/j.jvsv.2013.01.003

Objective It is customary to recommend wearing elastic band compression or compression stockings after treatment of varicose veins. Our aim was to evaluate the benefit from wearing elastic compression stockings after surgical treatment of varicose veins. Methods Prospective nonrandomized study with inclusion of consecutive patients operated on for unilateral varicose veins during a 6-month period with distribution in two groups: group 1, in which the patients were wearing an 18-mm Hg thigh compression stocking from the day of the operation until the postoperative consultation and group 2, in which the patients were wearing an 18-mm Hg thigh compression stocking for only 36 hours after surgery. The evaluation of outcomes was made at the postoperative consultation and concerned pain (self-evaluation by visual analog scale) and analgesic consumption, ecchymosis (self evaluation by visual analog scale), edema (circumference of the ankle), deep or superficial venous thrombosis (ultrasound duplex), quality of life by Chronic Venous Insufficiency Quality-of-Life questionnaire, and duration of postoperative sick leave. Results Fifty patients were included in each group for a total of 100. There was no significant difference between the two groups with regard to demographics, to clinical and hemodynamic characteristics, and to the type of surgery performed (phlebectomy, 32% vs 32%; ambulatory selective varices ablation under local anesthesia, 46% vs 48%; stripping, 10% vs 12%; redo surgery for recurrence, 12% vs 8%). All the surgical procedures were carried out under tumescent local anesthesia. At the postoperative consultation, we did not observe any significant difference between group 1 and group 2 for pain score (0.6 vs 0.8; P  = .35), analgesic consumption frequency (8% vs 12%; P  = .50), ecchymosis score (1.3 vs 1.2; P  = .49), and quality-of-life score (7.00 vs 8.64; P  = .43). The circumference of the ankle was not significantly different for the side operated on before and after surgery, for group 1 (25.6 cm vs 26.2 cm; P  = .30) and for group 2 (25.5 cm vs 26.2 cm; P  = .28). No superficial or deep vein thrombosis was found. There was no difference in sick leave frequency (26.7% vs 32.3%; P  = .57) and duration (2.6 vs 2.3 days; P  = .83). Conclusions We found no benefit from wearing the compression stocking beyond the first postoperative day for pain, ecchymosis, quality of life, and thrombosis after a mini-invasive surgical treatment for varicose veins carried out under tumescent local anesthesia with immediate ambulation.