Varicose veins are a serious disease that is not only an aesthetic defect, but also leads to impaired blood circulation. A person's life is deteriorating. Conservative therapy can give an effect only in the initial stages of the development of pathology, in the presence of complications, the patient is prescribed a combined phlebectomy.
What is an operation?
Combined phlebectomy is the removal of diseased blood vessels. Some pathologies lead to an increase in their lumen, as a result of which blood pressure decreases. In this case, the heart should work much more.
To get rid of the problem, the vessel has to be removed. The main task of combined phlebectomy is to normalize blood circulation. It is performed on an inpatient or outpatient basis. It all depends on the severity of the lesion. The intervention involves the use of several techniques.
Indications for use
There are various indications and contraindications for combinedphlebectomy. The operation is assigned in the presence of such problems:
- Pain and burning sensation in the lower extremities.
- Swelling of the legs and their chronic fatigue.
- Distended veins.
- Thrombophlebitis at the initial stage.
- Stagnation of blood in the legs.
- Venous insufficiency.
- Dilation of the great saphenous vein.
- Soft tissue and skin ulcers.
Combined phlebectomy is performed if the pathology extends above the knee.
Contraindications for use
If varicose veins are diagnosed, vein removal can not always be performed. There are such contraindications to the operation:
- Persistent increase in pressure.
- Ischemic heart disease.
- Problems with immunity.
- Old age.
- Diabetes mellitus.
- Acute deep vessel thrombosis.
- Inflammatory or infectious skin diseases.
- Pregnancy.
- Breastfeeding.
- Atherosclerosis of the legs.
- Menstruation in women.
If a person is at risk, then with varicose veins, the removal of affected areas can be prescribed, but there is already a question about the type of procedure.
Advantages of surgery
With varicose veins, surgery will help get rid of the symptoms. It has the following advantages:
- Reducing the likelihood of further development of the disease, since after the removal of largevessels, they will not be able to grow again.
- It is possible to perform the operation simultaneously on two limbs.
- Achieve a noticeable cosmetic effect.
- Short rehabilitation period.
- After the intervention, the scars are almost invisible.
The specified operation can be carried out by OMS. In addition, combined phlebectomy, the course of the operation involves the combination of several procedures, is carried out quickly and simply.
Disadvantages of the operation
Despite all the advantages, this procedure may have disadvantages. First of all, it requires anesthesia, which is not for everyone.
The operation should be performed by an experienced surgeon, otherwise there is a risk of damage to he althy blood vessels, nerve endings. After the intervention, bruises, age spots often appear. Most often they disappear during the first weeks of the postoperative period, but the spots can remain for life.
Possible Complications
After the combined phlebectomy, the reviews are mostly positive. A person's vital activity improves, he can walk without pain. However, the procedure can also lead to some complications:
- Heavy bleeding during surgery. It is not always possible to quickly stop it. More often this complication occurs in those patients who have problems with the blood.
- Persistent pain in the legs, the appearance of seals, which can also be painful.
- Desensitization in the limbs. This condition is typical for those patients in whom during the operation were damagednerves,
- Festering. This complication appears due to non-compliance with the rules of septic and antiseptic.
Sometimes a patient develops deep vein thrombosis after an intervention. In case of complications, the patient needs drug therapy. It will help to quickly remove postoperative symptoms.
Patient examination
Before removing damaged vessels, a person should be carefully examined. The main diagnostic method is ultrasound of the veins and vessels of the lower extremities. The study will allow assessing the severity of the pathology, the location of damaged vessels and choosing the appropriate removal method.
During the diagnosis, marking of the veins is done. This requires duplex ultrasound scanning. Additionally, a urine and blood test, a blood test (coagulogram) is performed. To prevent complications, it is also necessary to carry out fluorography, ECG.
Preparations
Phlebectomy needs preliminary preparation. Here the patient needs to wear compression underwear for several weeks, use prescribed drugs, and also undergo a course of physiotherapy.
Immediately before the intervention, you should shave your legs, prepare compression stockings or an elastic bandage. On the eve of the evening it is forbidden to have dinner, drink medicines. You also need to do an enema, as it is forbidden to go to the toilet for several days after the operation. You should also take a shower.
Stages of implementation
When appointing a phlebectomy of the veins of the lower extremities, the course of the operation includes the following steps:
- Crossectomy. At this stage, the great saphenous vein is ligated. After that, in the place where it flows into the deep venous system, it is crossed. The movement of blood through the vessels stops. This stage can be carried out both at the beginning of the operation, and at the time of its completion. It is not always needed, only when the risk of deep vein thrombosis increases. For removal, an incision is made on the inside of the leg under the knee or in the groin.
- Striping. After crossing the vein, it is completely removed. This procedure is radical. However, only a small part of the vessel can be removed in this way.
- Ligation of perforating vessels. It is carried out after the subcutaneous vessels have been eliminated. These veins connect superficial and deep vessels.
- Miniphlebectomy. This stage is considered final. It involves the removal of damaged fragments of veins. Such a procedure can be used as an independent full-fledged intervention.
After the operation, small cosmetic sutures are applied to the incisions. After the skin has healed, traces of them are almost invisible. Sometimes the edges of the incision are glued together with special surgical patches to connect the soft tissues.
If necessary, some of these stages can be replaced by more gentle methods of treating varicose veins: radiofrequency or laser. Standardthe duration of the procedure does not exceed 2 hours.
Rehabilitation process
After combined phlebectomy, the postoperative period requires full compliance with the doctor's recommendations. Its duration is 6 months. The rehabilitation period begins even during the patient's stay in the hospital. Stitches after removal are removed after 7 days.
During the first 3-4 hours the patient remains in bed. But he should not be passive. At this time, he performs simple exercises: turning his ankles, turning from side to side. Such exercises will help restore normal blood circulation.
The patient will need to wear compression stockings for another month after the intervention. And you have to wear them around the clock. Such underwear improves the speed of blood flow.
It is possible to wash the operated leg only after the stitches have been removed. This should be done very carefully. After this period, stockings are allowed to be removed at night. It is forbidden to tear off the crusts formed at the site of the seams. This area needs to be lubricated with antimicrobial agents for some time. They will help prevent infection from entering the wound surface.
Within 2-3 months after the intervention, the patient should not go to the bath, visit the sauna, take a hot bath. In this case, compression underwear should continue to be worn during the day. In the first days after phlebectomy, the patient is prescribed phlebotonics and painkillers.
In addition, the following remedies are prescribed to the patient:
- Drugs based on salicylic acid,"Pentoxifylline". They normalize microcirculation.
- Products containing ginkgo biloba.
- Antioxidants.
To speed up recovery, you will need multivitamin and mineral complexes. The drugs are given in a course that lasts 14 days.
Additionally operated physiotherapy procedures are prescribed. They prevent the development of inflammatory processes and trophic disorders. The patient will be helped by quartz irradiation, UHF therapy.
What to do at home?
During recovery, you need to go swimming, walk more in the fresh air. You also need to follow the following recommendations of specialists:
- Wear only comfortable shoes that will not constrict or crush your foot.
- Do not lift more than a kilo.
- Required to keep limbs elevated while resting.
- It is forbidden to stay in the same position for a long time. If a person has a sedentary job, then it is worth periodically stretching both legs.
- After discharge, the patient is assigned moderate physical activity (physiotherapy exercises). It should be done regularly. Exercises are performed standing on the floor (tilts down, while the fingers should touch the floor, and the legs remain straight), sitting on the floor (leaning forward with legs wide apart), kneeling (walking kneeling forward and backward with arms spread apart). You can also perform circular movements of the legs, standing on toes.
- Quit smoking and drinking alcohol.
- Eat rationally and fully. Dietinvolves the use of those products that thin the blood, strengthen the vascular wall. The diet should not contain fat. Need more fruits and vegetables.
If itching appears in the scar area, then it should be treated with iodine. Self-massage will help you recover faster. It prevents the appearance of blood clots, congestion. Any movement must be done carefully. Massage must be prescribed by a physician.
Varicosis is a dangerous disease. With untimely treatment, it can provoke tissue death and loss of limbs. The operation to remove the affected vessels is a radical method of dealing with pathology, but it allows you to restore normal life.
