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  • Questions about my recovery following varicose vein treatment
  • Advice following varicose veins procedures
  • Advice on thread vein sclerotherapy
  • Advice on thread vein laser therapy
  • Which treatment is best for my varicose veins?
  • Flying and varicose veins
  • Does my weight influence my varicose veins
Questions about my recovery following varicose vein treatment

How long will I be off work?

The time away from full activities varies with each person. However we would expect you to be up and about the day of the procedure and certainly walking around the next day. The leg may ache and feel sore, but this will settle over a few days. Plan to be back to normal in a week to 10 days, although the bruising, that is sometimes present and can seem extensive, will take a little longer to settle.

Could I get a Deep vein thrombosis after my surgery?

It is possible to suffer a deep vein thrombosis after you have had any form of surgery and this includes any of the different types of varicose vein procedures.

The risk of this however is very low (about less than one person in every two hundred people operated on)

We aim to get this risk even lower by giving you a small dose of the blood thnining drug heparin during the operation, making sure you get up and walk around as soon as possible after the procedure and asking you to wear your support stockings for a few days afterwards.

For more information please see our blog (click here).

Advice following varicose veins procedures

The following are suggestions you may find helpful after your operation.

1. When you leave hospital you will be wearing support stockings.  These are best worn day and night for the first week and then when you are not in bed, for the next four weeks.  They should be removed when having a wash.

2. Two days (48hours) after discharge take the stockings down and have a wash. A short shower is acceptable, but do not lie in a bath.  Afterwards when drying the leg, dab the wound dry.  The steri-strips (paper tapes) over the wounds will usually have come off in the shower within 2 weeks.

3. Occasionally the avulsion sites on the leg will weep a little stained fluid (this can look a lot in the shower).  Sit down and with a piece of tissue push over the wound.  This will settle after 5 minutes.

4. The leg is often bruised.  This will settle within two-three weeks

5. The leg often feels stiff and a firmness can be felt under the skin.  Occasionally these are uncomfortable.  This is part of the healing process and will settle.  This is eased by exercise and regular daily walks are a good idea.

6. It is important to get the legs moving after surgery, and to avoid prolonged standing: frequent walking is better than occasional long walks.  When not walking about it is advisable to elevate the leg for the first 10 days or so.

7. There is no harm in becoming active and getting back to work quickly, but it is sensible to plan for a couple of weeks off after most varicose vein operations

8. Do not drive for a week to 10 days.  Only go back to driving if you are sure you could make an emergency stop without pain!

9. If there is a groin wound this will also feel a little firm and stiff after a few days, but all will settle within 2 weeks

10. If you need any other advice please contact us.

Advice on thread vein sclerotherapy

The following general information has been compiled using the recommendations of the Vascular Society of Great Britain and Ireland and our experience of patients concerns.

1. About the treatment.

Injection (sclerosant) therapy is usually only suitable for relatively small varicose veins and thread veins, which are unsightly but cause no symptoms. It works by making the vein wall stick to itself, thus obliterating it, and the compression applied after the injection is an essential part of the therapy.

2. Before your next visit.

If you have a job that involves a lot of standing, please arrange to have a few days off after the injection. Avoid commitments that will prevent you from resting for the first few days after treatment.

3. At the clinic.

A small amount of fluid is injected into the vein at one or more sites and a cotton wool or rubber pad applied. A bandage is then put onto the leg and a stocking applied to prevent the bandage from working loose.

Usually only one leg is treated at one visit and repeat injections will be required if both legs are affected or you have many veins on one leg.

Please do not drive yourself home from the clinic. Arrange for somebody to collect you or take a bus or taxi.

4. Afterwards.

For the first 24 hours rest as much as possible, sitting with the feet elevated above the level of the hips. Take a few short walks and try to avoid standing still for any length of time.

After 48 hours you should remove the bandage and cotton wool pads and replace stocking. This should be worn at all times during the day but can be removed in bed and when taking a bath or shower. You may drive once the bandages and pads have been removed.

The success of the injection treatment relies upon the pressure that the bandages and stocking apply to the injected area. Wear the stocking until the leg is completely comfortable on standing (usually 1-2 weeks).

5. What to expect after the injections.

Over the first few weeks following the injection, any slight discomfort, hardness or tenderness at the injection site(s) should gradually subside. If there is excessive redness, swelling or tenderness, this means you should rest more with the leg raised so that the heel is higher than the hip.

While most patients experience no problems after injection of varicose veins, a small number may experience one or more of the following:

• A persistent hard “cord” in the line of the vein.

• Brown staining of the skin in the line of the vein.

• Rarely, ulceration of the skin at the injection site.

• Failure of the injection to obliterate the vein (i.e. the thread vein remains).

For the future it may be advisable for you to wear light support stockings or tights to try to prevent the occurrence of further varicose veins.

Advice on thread vein laser therapy

The following information is based on that provided by the British Association of Aesthetic Plastic Surgeons. I hope you find it helpful.

Are all thread veins suitable for Laser therapy?

Not all thread veins respond to Laser therapy, especially if they are situated too deeply within the skin for the Laser light to penetrate. In such cases, Sclerotherapy may be effective.

How does Laser therapy work?

Lasers produce light of a very pure wavelength. If the wavelength of the Laser is matched to a target colour (such as the red of blood or the vessel wall), the energy of the Laser is absorbed specifically by the target but not by the surrounding tissues. Thus, the Laser delivers a series of focused energy pulses generating heat for very short periods of time. This breaks down the thread veins into tiny particles. These tiny particles are then dispersed naturally in the body and the veins fade over several weeks.

What is Laser treatment like?

The laser is fired in short bursts at the thread veins. This feels warm on the skin, like a pinch similar to a snapped rubber band. During treatment the skin is cooled which reduces this sensation. Local anaesthetic gel can be used if necessary. The entire procedure is brief and non-invasive.

When laser treatment is carried out it is essential that all those within the treatment room, you and the staff, should wear protective goggles or glasses. Entry to the room is strictly controlled whilst treatment is being given.

What preparations must I make?

Do not make changes to your normal activities, before or after treatment. Prior to and following any laser treatment, you must limit your exposure to the sun. Treatment is not recommended in patients who are tanned.

First treatment: the Test Patch

Laser light can damage the skins pigment and sometimes the treatment area may become unusually pale or dark several months after treatment. For this reason, it is wise to carry out a small trial of treatment in an unobtrusive area before proceeding to extensive treatment. The test patch is examined six to eight weeks later for unwanted side effects and to carefully assess success before proceeding to further treatment. Special care is needed when treating patients with brown skin.

After the treatment?

After a treatment the treated veins appear red, bruised, raised and often more prominent than before the treatment and the surface of the skin may feel dry. Crusting may develop on the area that has been treated. Occasionally there is a slight increase in pigment at the treated site. This usually subsides after seven to fourteen days.

After treatment stay out of the sun as exposure of recently laser treated skin to strong sunshine may increase the risk of pigmentation problems.

How many treatments will I need and how often?

The number of treatments needed will depend on the extent of the affected area and will be estimated at the consultation. Treatments are usually planned at four to six week intervals.

Complications of Laser therapy

In general Laser therapy is safe and effective, however complications do sometimes occur and these include: blistering, scarring, ulceration, loss of skin pigment and increased pigmentation, which may be permanent. The area around the ankle is more likely to have complications than other areas. It is important that you give details of any medication you are taking, and any medical problems you have, which may be relevant to the treatment.

The risk is greatest is patients known to produce keloids, who have been treated with radiotherapy in the area or have had a recent course of Roaccutane. Cold sores (herpes) can be reactivated. Patients with this tendency can be given preventative treatment.

Which treatment is best for my varicose veins?

There is a lot in the popular press about which is the best way to have your varicose veins treated and making a decision is often difficult! Should you go with a new technique or stay with a well established one that has proven long term result?

The first thing you need to decide on is do I need my veins treated and do I want treated?.

If you do want treatment, the next step is to obtain advice from a vascular surgeon with a specialist interest in venous disease. Make sure that the specialist has a big practice and is able to offer you a range of different treatments. The hospital where they may do the procedure also has to have the facilities to offer you the same range of treatments. This will ensure you get an unbiased opinion based entirely on your particular circumstances.

Do not make a final decision until the specialist has undertaken or reviewed the results of your venous duplex scan. This provides the anatomical and physiological information vital to ensure accurate personalized information  can be given.

Do not let the type of anesthetic you want or are offered influence your decision on the type of procedure you want as all procedures can be undertaken either under local or general anesthesia or a half way house of sedation. Which ever you decide on it is usually recommended to have an anesthetist in the room with you and the surgeon.

Finally most techniques (high tie and stripping, endovenous radiofrequency ablation, endolaser ablation, Chiva andfoam  sclerotherapy) can give good initial results in the hands of a good surgeon. Long term results, in particular recurrence rates at five and ten years are known for the more established techniques and are being sort by the newere ones.

Flying and varicose veins

Varicose veins, air travel and venous complications remain a cloudy issue, with surprisingly little convincing and specific literature dedicated to the matter.

There is little justification for  people  with varicose veins to be prevented from flying or that medical prophylaxis should be taken. Due to confusion on the matter and perhaps to relieve anxious patients, those with primary varicose veins should stay active during a flight, but again there is not solid evidence to prove that this is necessary or sufficient to prevent thromboembolism. There is also an argument for compression stockings in varicose vein patients.

Due to the probable benefits of mobilization during flights, it is also wise to postpone flying until the leg is back to full function following varicose vein surgery.

Does my weight influence my varicose veins

Weight (a raised Body mass index) does increase the risk of you getting varicose veins and getting the complications of venous disease.


Daryll Baker is a Consultant Vascular Surgeon at the Royal Free Hospital London and Clinical Lead for North Central Region Vascular Services.

He read Medicine at Oxford University and trained in Vascular Surgery in Nottingham, London and Edinburgh. He obtained his research PhD from the University of Wales.


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