Operative Note:Varicose Veins

Name of procedure

Varicose Veins right lower limb, T3 elective, General anaesthetic

Indication

Phlebitis, Clinical and Duplex evidence of right sapheno-femoral incompetence

Preparation and prohylaxis

• Veins marked in ward prior to arrival to theater
• Side of operation marked and initialled in ward prior to arrival in theater
• Co-Amoxiclav (Augmetin) 1.2 g IV given at induction,
• Enoxaparin (Clexane) 40 millegrams SC given in ward prior to transfer to theater. Patient wearing TED stocking on left lower limb

Fidings

Right saphena varinx, several varicose veins in medial calf adherent to skin from previous phlebitis

Incision

Right groin crease and multiple stabs

Procedures

A

Flush ligation of right sapheno-femoral junction, junction defined, tributies ligated, junction flush ligated with 3/0 vicryl

B

Stripping of right long saphenous vein in thigh

C

Multiple stab avulsions of above and below knee varicosities

Closure

Groin; 3/0 vicryl to fascia and 4/0 monacryl s/c to skin, meepore

Stabs; Steristrips, meepore and above knee compression bandage with wool and crepe

Post operative instructions

• Post GA observations
• See anaesthetic orders
• Analgesia as charted
• Monitor lower limb for evidence that bandage is

  too loose

  Manifest by bleeding

  too tight

  Manifest by pain, decreased circulation, pins and needles

• Monitor circulation, movements and sensation in operated limb
• Patient will require instructions regarding post operative care of the limb prior to discharge