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Varicose veins surgery

Varicose veins are a problem for both men and women

Varicose veins are a problem for both men and women irrespective of their age. Though they appear more often in women, who have greater predispositions than men, e.g. pregnancy or changes from aging.

Varicose veins are enlarged veins, which are usually blue or purple clusters, which form a meandering network and are swollen above the surface of the skin – they resemble earthworms. Any vein can become varicose, but they usually appear on the thighs and calves. Varicosis affects the surface veins.

Varicose veins are most of all an aesthetic problem, but can cause other problems as well:

• pangs of pain,
• legs that seem heavy,
• swelling,
• itching,
• spasms may also occur when the problem develops further and the blood flow becomes slower – in this case you should definitely see a doctor.

Varicose vein surgery can only bring relief to the problem, but it is possible that new "earthworms" start to develop in time – there isn't an effective treatment for this problem. However, having the surgery is so far the most effective. Removing varicose veins does not affect the blood stream in the legs, since the inner blood vessels that are deeper beneath the skin will not be touched.

Varicose veins surgery

All the visible and severely varicose parts of veins, primarily those which may cause an infection or complications, are removed during the surgery. You will have an ultrasound before the surgery to determine where and which valves in the vein are not working properly.

The surgeon will probably make markings on your legs, because the lumps are not so visible while lying down as they are standing up. Your legs might be shaved if needed. According to the patient's wishes and the amount of varicose veins that are removed, the surgery will be performed under general anesthesia or a local sedation in the spine.

The most usual technique is to close the varicose veins and remove them. Whether you need one or two incisions depends on the problem, but usually two are made.

The procedure is actually quite simple and doesn't take much time.

• One five cm incision is made in the pubic area, in the upper part of the thigh vein, and another two cm incision will be near the knee or ankle (depends on whether a part of the vein or the entire vein is removed).
• The vein in the pubic area is closed from the top (sometimes from the bottom), where it meets with the deeper veins, to stop blood flowing through it.
• Next, a probe is inserted to the vein through the upper incision and the varicose vein is carefully removed through the lower incision.
• After that the incisions in the pubic area and knee or ankle are stitched and the surgeon will tie an elastic bandage around your leg.

The surgeon will usually make many smaller incisions as well (about five mm) to remove smaller lumps. These incisions are not stitched, but "patched" with a strip of cloth. Varicose veins could also be just closed and not removed from the leg. In this case they will not remain lumpy and visible, since blood does not flow through them any more. Neither of the methods influences the blood circulation, since blood will flow through other veins.

Pre-surgery and post-surgery advice

It might be necessary to shave your legs before the surgery and you should certainly take a shower the same day. You should also stop smoking for some time before the surgery, since it hinders recovery. You must not eat or drink six hours before the surgery. Drinking alcohol is prohibited one day before the surgery and about 48 hours after it.

Activities, which may cause injuries to the patient and also other people, e.g. driving, are prohibited after the surgery (due to anesthesia). It is recommended to lie down for a few hours right after the surgery. You can take painkillers if you need.

It is recommended to walk at least half an hour a day in the following days. You should avoid sitting for a long time or lying down and you should keep the wound dry for a couple of days. The sutures will be removed after 10 days. You have to wear an elastic bandage for a few days and support stockings for a while after the surgery (1 – 2 months), since these help to speed up the recovery. Moderate exercising (swimming and cycling) during recovery is only good for you. You can start with active physical activities in about a month.

Taking care of your legs and avoiding varicose veins

People, who have had problems with varicose veins in their family, should take extra care of their legs – they have a hereditary predisposition as their connective tissue is weaker due to genetical transmission. Hormonal changes, such as puberty, pregnancy, and menopause quicken the process in women. Therefore, women in all ages can develop varicose veins.

There are many things that can be a predisposition to varicose veins:

• standing up for long periods of time (e.g. salespersons, hairdressers, etc.),
• sitting for a long time (people working with computers, chauffeurs),
• keeping your legs in a constrained position,
• excessive heat (sauna, hot bath, sunbathing and the like),
• being overweight,
• wearing high heels.

Varicose veins are a cosmetic problem at the beginning – blue veins and clusters shining through your skin and surface on the skin might start to disturb you. Infections and ulcers may occur if the condition develops further and this is harder to cure. Therefore, it would be wise to see a doctor when the disease is in the initial phase: when varicose veins appear and your legs feel heavy, tired and painful.

The bluish veins might not be visible at all, but the patient has symptoms that indicate varicose veins. You should start wearing support stockings when there is only one varicose vein "adorning" your leg. The stockings might help the varicose veins to recede: they will channel the blood towards the heart and prevent it from accumulating to the veins.

People, whose job requires them to sit or stand, should put their legs to the table once in a while or just keep them elevated, so that blood could flow back to the body. It is recommended to avoid standing or sitting for a long time, hot showers and the sauna as well to prevent varicose veins. You should also avoid high heels and keep your weight stable. You should exercise whenever it is the least possible.