Despite the fact that in the arsenal of plastic surgeons there are many treatments for varicose veins, such as laser photocoagulation or radiofrequency ablation, some others, traditional phlebectomy continues to be used in cases where, for some reason, it is impossible to use microsurgical methods. In addition, phlebectomy is performed urgently if the patient has a risk of bleeding from the affected vein or has already happened before. Unfortunately, phlebectomy of one affected vein is no guarantee that similar inflammation will not occur in other veins.
The essence of the phlebectomy operation, indications and contraindications
The operation of phlebectomy consists in the removal of the trunk, perforating veins and tributaries affected by varicose veins from the system of the great saphenous vein. Since only 10% of the blood circulates through the saphenous veins, and the rest of the blood flow falls on the deep veins, phlebectomy does not cause damage to the body. At the same time, the purpose of removing a vein affected by varicose veins is to prevent the progression of the disease, the development of thrombophlebitis and trophic ulcers, normalize blood flow through deep veins, and prevent bleeding from veins damaged by varicose veins. A pleasant addition to the results of phlebectomy is the aesthetic improvement in the appearance of the legs.
The indications for phlebectomy are the following:
- extensive varicose veins;
- swelling, heaviness in the legs; fast onset leg fatigue;
- trophic ulcers;
- acute thrombophlebitis;
- abnormal dilatation of the great saphenous vein.
Even if the saphenous vein has not changed externally, but there are trophic disorders that are not amenable to conservative treatment, this is an absolute indication for phlebectomy.
Contraindications for removal of the great saphenous vein:
- ischemic heart disease;
- resistant arterial hypertension;
- pregnancy;
- infectious diseases;
- late stage varicose veins;
- inflammatory skin diseases (eczema, pyoderma).
Phlebectomy operation and postoperative recommendations
The phlebectomy operation includes several successive stages: ligation and removal of the great saphenous vein (crossectomy), ligation and removal of incompetent perforating veins, removal of tributaries affected by varicose veins.
After the operation, it is essential to observe the mode of wearing compression stockings or elastic bandages. It is recommended to take venotonic drugs, moderate activity to prevent thrombosis.
Complications after phlebectomy can be hyperpigmentation along the removed vein, subcutaneous hematomas, rough scarring of the wound. In more serious cases, there is infection of the wound, the formation of fistulas, the formation of deep vein thrombosis.
Share:
Add a comment