Consent:Varicose veins

Nature

Operation to reduce leak from deep veins into the superficial veins and to remove the dilated and torturous superficial veins.

• Tie off the leak from the deep veins into the superficial veins
• Remove part of the large vein that carries the leaking blood to fill the varicosities
• Remove the varicosities

Following the operation the lower limb is bandaged for 24 to 48 hours. The bandage is replaced by a stocking that is worn day and night for 2 weeks. Following which the stocking is worn by day only for at least a further 2 weeks.

Two days after the operation the patient is advised to walk for fifteen to twenty minutes daily.

When the bandages are removed, the patient may shower and wash the lower limb.

Alternatives

• Do nothing
• Wear a stocking or strong hose
• Injection therapy (for small veins)

Benefits

Loss of unsightly veins. Healthier skin for people with phlebitis or ulcers.

Risks

• Risk of the anaesthetic.

• Bleeding, infection and ugly scar from any incision.

• Risk of hematoma especially at site of ligation of leak from deep to superficial veins but also anywhere where incisions are made. Low risk of requiring a second operation to remove collection of blood.

• Risk of cutaneous nerve damage especially where incisions are made to remove the varicosities. Cutaneous nerve damage occurs in 4-5% of operations. Cutaneous nerve damage may result in temporary or permanent decreased sensation and in some people results in a pins and needles sensation like nettle stings, which may be temporary or permanent.

• Residual veins are commonly seen following varicose vein surgery. Sometimes veins are missed because they have not been marked or they are stuck under the skin, due to previous phlebitis or injection sclerotherapy.

• Varicose veins may recur following surgery and about one in ten operations that are done for varicose veins are redo operations.

• Deep venous thrombosis and its sequelae.