Duplex
ultrasound examination will pinpoint the veins
that require treating and these will be marked
prior to surgery.
Usually
performed as a day case with a light general
aneasthetic.
A
special Swiss instrument is used to perform
inverted stripping, a method that causes less
bruising and pain.
Smaller
visible veins are removed with Swiss Oesch
hooks which require a tiny nick in the skin
and no stitches. These heal without scarring.
Compression
stockings are worn for 10 days and patients
may find it necessary to take 2-3 days off
work. It is not permissible to drive for 24
hours but driving may be resumed when the
patient is able to comfortably perform an
emergency stop. It is advisable to walk regularly
throughout the day
Following
surgery the remaining reticular varices and
thread veins can be treated with sclerotherapy
Arteries bring blood from the heart to the
extremities. Veins contain one way valves and channel blood back to the
heart. When there is obstruction of veins, or when prolonged pressure is
placed on the veins, the valves stretch and no longer close properly. This
allows blood to travel back down the veins towards the feet. The veins in
the legs that are near to the surface of the skin enlarge and result in what
is commonly called varicose veins. These can range from minor dilatations
to large bunch of grape-like structures in the calf. Very small purple or
blue
veins in the skin of the legs are called "thread veins" or "spider veins" or
dermal flares and often occur alongside large varicose veins. Some people
are only
affected by dermal flares. Both types of varicose veins are probably caused
by the same factors. Varicose veins is a slowly progressive disease which
if left untreated can lead to marked skin change damage or ulceration near
the
ankle.
Why do varicose veins arise?
Varicose Veins, Thread Veins, Spider Veins,
PhotoDerm, Sclerotherapy, Surgery, Thrombosis
Heredity is important in the development of varicose veins, thread veins
and spider veins. Up to 20% of the adult population have varicose veins and
experience discomfort as a result. Many people know of other family members
with the same problem. A recent study showed that where both parents had
varicose veins there was an 80% chance of their children developing varices.
Environmental factors also play a large part in the
development of varicosities, for example, prolonged standing - especially
for workers such as nurses, sales assistants, flight attendants, waitresses
and teachers, for example. Diet may also be a factor, and our Western diet
with high content of fat and refined sugar with low fiber content may
contribute to the development of varicose veins, spider veins and thread
veins. Varicose veins may also
become more frequent with advancing age, but may appear at any time of life
and small varices are sometimes seen in school children.
Although all factors such as puberty, pregnancy and the
menopause also influence the course of the disease. As many as 70 - 80% of
pregnant women develop varicose veins during the first trimester. Pregnancy
causes an increase in hormone levels and blood volume which in turn causes
veins to enlarge. Later in pregnancy, the enlarge uterus causes increased
pressure on the veins in the pelvis. Approximately 60 - 70% of varicose
veins due to pregnancy will disappear within a few months of delivery.
Little research has been done to investigate the role of
the pill and hormone replacement therapy (HRT) in the development of
varicose veins. These probably have no influence on them.
What are the symptoms
Treatment of varicose veins and thread veins by injections sclerotherapy
PhotoDerm and surgery Varicose veins may cause feelings of fatigue, heaviness,
aching, burning, throbbing, itching and cramps in the legs. These symptoms
are often accompanied by swelling of the ankle, which frequently appears
after long hours of standing. Some people are very troubled by the aching
that varicose veins produce. Even small dermal flares can result in severe
aching which prevents standing for any length of time.
What can I do to prevent them?
Treatment of varicose veins and thread veins by injections sclerotherapy
PhotoDerm and surgery
Many of the things that seem to cause varicose veins are
difficult to avoid such as a family history of Western way of life. Where
possible standing still for long periods should be avoided. Walking is much
better for the veins and helps the blood return to the heart from the legs.
In occupations that require extended periods of standing then a few steps
should be taken at regular short intervals to help circulation. Wearing
support stockings may also reduce the likelihood of varicose veins. No
creams or drugs are available to prevent varicose veins. The earlier
varicose veins and dermal flares are treated the better the long term and
cosmetic outcome.
