Varicose veins of the lower limbs is known for a long time the mankind. About 30% of the world population suffers from varicose veins in the legs. In 25% of patients without treatment if you develop serious complications (thrombophlebitis and trophic ulcer). The patient it is important to understand the following, that varicose veins is the complete degeneration of the venous wall, and without the intervention of a doctor, the disease will, unfortunately, only progress!
There are methods conservative, operating and non-operating, the treatment of varicose veins. The non-operating techniques belongs sclerotherapy. Today is the surgical treatment of varicose veins of the disease is one of the main. However, it is worth immediately noting that the surgical treatment is shown not all patients with this disease. Surgical treatments include: ligation (ligation of the vein), Stripping, microphlebectomy.
Varicose veins of the lower limbs, can be called "popular disease". More than 40% of women and 20% of men have symptoms of the disease. In 20% of cases of varicose veins, results in trophic ulcers, more than 25% of the patients move thrombophlebitis varicose veins.
Hereditary predisposition – varicose veins is the result of a congenital weakness of the connective tissue. Such patients may also have hernias, hemorrhoids, and t. d.
Over-load long-duration static load (standing still), or sedentary work, the rise and weight transfer, shoes with high heels, HypodINAME (malopodvignostü) – are the main contribute to the factors for the development of varicose veins.
The mechanism of varicose veins is pronounced, physical-to an overvoltage, pregnancy and childbirth. When the excess load occurs, the increased pressure in the veins of the lower limbs and damage to the valve apparatus.
Chronic venous insufficiency – a typical complication of varicose veins during which the prejudice of venous thrombosis output of the cause, pathological, condition, called chronic venous insufficiency. The disease is gradual, but continuously progressing. The swelling becomes persistent, it appears dark staining of the skin in the region of the ankles.
Thrombophlebitis when varicose expansion of a vein – in screen venarum thrombosis called of inflammation of the vein wall with the formation in the lumen of the vein from a clot of blood. When varicose expansion of veins venous thrombosis occurs in 25% of patients and, sometimes, it is difficult to ttromboembolia the pulmonary artery.
Varicose teroticheskaja ulcer wound not healing time that occurs when serious violations of venous thrombosis outputs of the deep and superficial veins. They are marked with 1% of the entire population and 20% of patients with varicose veins. Trophic ulcer appear during the execution of stages of varicose veins.
Offering from varicose veins – varicose veins of the lower limb – occurs in 20-40% of the population of the developed countries of the world. The long-time varicose veins feet is only a defect, however, the progression of the disease leads to the onset of pain, edema of feet and legs, but in phases the darker skin of the integument of the feet, changes the chronic and trophic ulcers.
Secondary varicose veins post – trombotnical disease. Develops after suffering a venous thrombosis or due to congenital diseases (arterivanskii fistula congenital venous dysplasia). Post trombotnical disease – heavy next the disease process in the venous system of the lower limbs. Because of the failure valvular, which develops as a result of thrombosis, the blood through the deep veins starts to move up-down, you will get secondary varicose veins and you have the conditions for the venous stasis, especially in the lower departments of the soles of the feet and legs.
Indications of scleratERPII:
ScleratArabia can be applied as a method of treatment of varicose veins, as a complement to the surgical techniques.
The duration and the technique of execution scleratERPII
The procedure scleratERPII lasts 5 to 30 minutes, depending on the number of varicose veins, which you have to resolve.
The procedure scleratERPII performed with the patient in the horizontal position. Before the introduction of the medicine the patient must lift the leg, so that the blood in the veins of the glass down. The goal of such reception – to reduce the amount of blood in the vessel, for sclerosant not racestwas varelse it, and acted directly on the vein wall.
During a session of scleratERPII the doctor can do 5 to 10 accidents. The amount of the drug is determined by the weight of the varicose veins and a dose of scleraзandнtand. On average, the rate of healing can take between 3 to 5 sessions.
The advantage scleratERPII there are significantly lower cost in comparison with the operation without the need to be in hospital (ie, the patient can immediately go home), and also the faster recovery period.
Efficiency scleratERPII in the solution of the manifestations of varicose veins reaches 85%.
Indications for the surgical treatment of varicose veins
Surgical treatment use cases, when conservative treatment and lifestyle change does not help to eliminate the symptoms.
Usually Peel performed with the removal of varicose veins. In addition, the method of intervention applied to the warning trophic changes of the skin side, in the form of ulcers.
It is used to Peel, usually:
If you Have as small and large varicose veins may need more than one treatment method. Usually Stripping large varicose veins complemented sclera therapy more small branches of veins.
Most of the surgical techniques of treatment of varicose veins in the legs coming out of a clinic. That is, the patient should not be constantly in the hospital and after the operation, go immediately to the house.
Contra-indications for the treatment of such methods as ligation and Stripping
Before the operation, You should do the following tests:
You preferably 2 weeks before surgery do not take medications that affect blood clotting (eg, aspirin, cough medicines). Stop smoking for 2 weeks before surgery, as smoking impairs the healing process. Abstain from the consumption of alcohol.
If you have readings performed in other exams – implanted biochemical analysis of blood, ultrasound of organs, professional councils, and t. d. the Patient receives medical advice, which should comply with.
The operation expoliantes can be performed under local or general anesthesia. The duration and the technique of execution of an operation – Withtripping.
Withtripping is minimally invasive intervention, which was wound vienna is removed using a small thin probe. When this is accomplished, usually, two small incisions – one in the area of one end of varicose veins, the veins, the second for the other side. After vienna is in evidence, it intersects in two places, but in the light is introduced to a probe. The head of the fixed probe (dental floss) to the vienna final (or is, in the place of vienna, where they came the probe). Later, the surgeon removes by this probe vienna.
Usually Peel implemented for the removal of the vein from the groin to the knee fossa or knee pit to the bone.
Advantages exuere' – is that there is not much dissection throughout the city of vienna, and only the incision at the beginning and at the end of vienna. The first of the cuts will be in the region of the groin, where it will fully hide behind нandtелüным bed.
Today to apply the method of short-exuere'. Short Peel different, in that it is made the removal of only the dead segments of varicose veins and veins. In vienna with booking, normal valve remains without changes. This allows to reduce the duration of the operational intervention, tрandвмandtichnostü and improve the cosmetic effect.
Some of the advantages of short exuere' are: faster recovery period and the almost complete absence of the starting point of the pain syndrome in the perioperative period.
Previously, the doctors felt that the achievement of a exuere' is not desirable, in the sense that if, suddenly, the patient needs a heart surgery (coronary artery bypass grafting bypass surgery), vienna in the leg to be used as a bypass during this operation, is not able to. However, today there is a consensus that the varicose veins may not be complete shuntandми for this type of operation. In addition, in most cases, this kind of operation, the role of the derivation can play GRUdнandя the artery, and, in addition, for such purposes, may take vienna, with the hands.
Ligation is dressing of varicose veins and veins. Usually ligaturam methods do not apply separately, but only as a complement to the other – hlebectOhmии, expoliantes.
microphlebectomy is an operation in which varicose veins is removed through a puncture in the skin. The operation miniphlebectomy is minimally the operation, requiring the completion of a minimum of anesthesia.
miniphlebectomy is held by a hook, which is injected under the skin in the area of varicose veins of vienna with a slim-cut hole. This hook of varicose veins is pulled out, after which she перевязывandеtXia and crossed the ball. The same method is performed for the removal of other veins.
It's also worth mentioning the fact that the removal of the vein, in this way, such as Stripping or ligation, leads to the formation at the site of varicose veins, veins, bruising (bruises). But not to worry because they disappear 2 to 3 weeks after the application of ointments special. On the site of the puncture are virtually invisible and scars.
Among the advantages of miniphlebectomy it is worth noting the high efficiency, small tрandвмandtichnostü and the almost complete preservation of the integrity of the patient, and, of course, the beautiful cosmetic effect.
After the operations of removal of the veins recommendation will be different for every patient – it depends on the degree of the varicose veins, the volume of operations, the presence of chronic diseases.
From the first hours after surgery is recommended to turn, bend your legs and t. d. And the simple elevation of the edge of the bed in 8-10-cm improves the venous blood circulation.
The next day, after the operation to perform ligation with the application of compression of tissue mesh or elastic bandage on both feet from the tip of the toes to the groin. Is allowed to walk only after the bandage. Also after the removal of the vein recommended therapeutic exercise and massage as a prevention of blood clots.
7-10 days after the surgery, it's not worth practicing physical exercises, and also can take advantage of the steam bath or sauna. 8-9 day, we removed the seams and is assigned to the course of public health in physical education. Elastic compression is needed for at least 2 months after the removal of the suture.
Are particularly important exercises when varicose veins for elderly patients. This is the ideal for the prevention of post-operative complications – the slowing down of venous thrombosis output of blood and post-operative thrombosis. For the prevention of blood clots also prescribe medications.