Your varicose vein operation

Transcription

1 Day Surgery Centre Your varicose vein operation patientinformation Rotherham Hospital Your health, your choice, our passion

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3 Your varicose vein operation This booklet gives a guide to your day case varicose vein operation. It will also give you an idea of what it will be like afterwards. The booklet does not cover everything. If you want to know more please ask. What is a varicose vein? A varicose vein is a vein under the skin (subcutaneous) that has become swollen. Varicose veins often cause symptoms of aching and/or discomfort and if left, they can bleed, clot or cause ulcers. Varicose veins however, may not cause any symptoms at all apart from being unsightly. What does the operation consist of? Varicose veins can be cured by removing the veins that supply them, by tying the feeding veins off. The varicose veins themselves are then removed through small cuts. Sometimes the vein in the thigh is removed. This requires a cut in your groin at the top of your leg. All of this needs to be performed under a general anaesthetic. Please refer to You and your anaesthetic for more information. The operation can be done as a day case depending on your health and the majority of patients quickly return to their normal activities. 3

4 Requirements for a day case l No health problems requiring an overnight stay (your pre-assessment nurse or anaesthetist will determine this) l A responsible adult to take you home by car l A responsible adult to stay with you for 24 hours after your operation Are there any alternatives Varicose veins are not life-threatening and for most patients having surgery is not absoloutely necessary. To have the operation on the veins is the patients choice. The alternative to surgery is: l To wear support socks or stockings. These will help reduce the swelling and aching that the veins may cause l Laser treatment of varicose veins is a developing new treatment suitable for some patients, but long term results are awaited 4 What happens before the operation? You will be welcomed by the receptionist. You will have your details checked and the nurse will check your pulse, temperature, blood pressure and that nothing has changed since pre-assessment and that you are appropriately starved. You will be seen by the surgeon who will be doing the operation. The operation will be explained to you and you will be asked to sign your consent form for the

5 operation, if you have not done so already. If you are not clear about any part of the operation, please ask for more details. The surgeon will mark the position of the veins on your leg(s) with a marker pen. You will also be seen by the anaesthetist to check your health and to discuss your anaesthetic and pain relief. Will I have any pain after the operation? The surgeon will inject some local anaesthetic into the cuts when you are asleep to numb them. The anaesthetist will also give you some pain killer. You may feel some discomfort in your legs on moving, rather than severe pain. You will be given some painkilling tablets to control this. Ask for more if the pain is still unpleasant. At home, take your painkillers regularly by the clock or the first 48 hours to keep the pain away rather than waiting for it to hurt. Drinking and eating You will be able to eat and drink within an hour of the operation, providing you are not feeling sick. Before you go home The nurses will check that the groin wound is comfortable (if there is one), and that it is not bleeding. They will put elasticated stockings over the crepe bandages on your leg(s). These need to stay in place for 5 to 7 days after surgery. This will be specified on your discharge letter. 5

6 You will also be given a 2nd support stocking to take home with you, which must be worn after the district nurse has visited you, or you have visited the practice nurse at your GP s surgery. Please ask for a sick note if you need one. At home Rest quietly for the rest of the day following your operation. Next morning & the first few days You should be able to get out of bed quite easily despite any discomfort. You will not do the wounds any harm. You should go for short walks around the house, but rest with your feet up when not exercising. Exercise is good for you. The second day after the operation, you should go for short walks outside the house, and increase your exercise over the next few days. The bandages may feel quiter tight this is normal. Wear the white stockings over the bandages day and night for the first 5 to 7 days (see below). You need to avoid getting the stocking/bandages wet or dirty. Day 5 or Day 7 Depending on your Consultant, you will need to see the practice nurse at your GP s surgery 5 or 7 days after surgery. This will be specified on your discharge letter. A district nurse will be arranged instead if you cannot 6

7 go to your GP. The nurse will remove any stitches in the groin and remove the stockings, dressings and bandages. Leg(s) often look and feel bruised at this stage this is normal. Once the bandages are removed, you can wash/shower/ bathe as normal. The 2nd support stocking that you have been given should be worn during the day for the next 2 weeks or until the leg is comfortable. You can take it off to bathe and to go to bed. If the elastic stocking becomes slack, you can use suspenders to hold the stocking in place. General recovery You are likely to feel very tired and need rests 2 to 3 times a day for a week or more. You will gradually improve, so that after 2 to 3 weeks you will be able to return to your usual level of activity. You will see some purple or yellow staining of the skin from bruising which will fade away in a week or two. This is often seen in the upper thigh. There is often some swelling around the ankle which lasts a week or two. This is controlled by wearing the support stocking. There may be some lumpiness under the skin where the veins have been removed. This will settle down. The scars on your leg will be visible for many weeks after the operation before they start to fade. The leg will take 6 months or more after the operation to reach its best. 7

8 Walking Build up your walking gradually. If you are doing too much your legs will hurt or ache. There is no need to strive for 2 to 3 miles a day as is sometimes recommended. However, remember that walking is good for you. Try to avoid standing in one position for any length of time. When sitting elevate your legs and feet to avoid swelling. Driving & Work You can drive as soon as you can make an emergency stop without discomfort in the wound, usually after about 10 days. The nature of your work will dictate how long you are off work. You should be able to return to a light job after about 2 weeks and heavy job within 3 to 4 weeks. Complications While there are risks associated with any kind of operation, the vast majority of patients undergoing varicose vein operations have few serious problems. The operation should not be underestimated, but practically all patients are back to normal duties within a month. Complications are rare and seldom serious. If you think that all is not well, please phone the Day Surgery Centre or contact your GP. 8

9 l Bleeding from the wound is the most important thing to look out for. A little blood staining on the dressing is normal. If bleeding continues after getting home, phone the Day Surgery Centre on , Monday to Friday 8.00am to 8.00pm. (If after 8.00pm phone ). If you cannot get through, go straight to Accident and Emergency Department or contact your GP. The bleeding is not life-threatening but it can be a nuisance if allowed to continue. l Bruising and swelling may be troublesome, particularly if the varicose veins were large. The swelling may take 4 to 6 weeks to settle down. It occasionally needs some cream (Hirudoid) that your GP can prescribe for you. l Infection in the groin wound can occur (5% of patients) and may require antibiotics. l Occasionally there is numbness in the skin, where a skin nerve has been damaged by one of the tiny skin cuts. This may take up to a year to improve but is permanent in a few patients (under 5%). l Other complications include formations of clots in the deep veins of your legs - deep vein thrombosis (DVT). This is uncommon (less than 2%). Very rarely such a clot may travel to the lungs - Pulmonary Embolus (less than0.5%). If your leg swelling increases or you feel short of breath contact your GP or Accident and Emergency Department. 9

10 l Unfortunately, recurrence of varicose veins often occurs. Treating varicose veins is something of a running battle. Sometimes new veins appear or veins which were not noticed before the operation become more obvious afterwards. Make sure that all the veins that trouble you before your operation are marked with the skin pencil and tell the surgeon about any problem vein. Sometimes thread veins appear after the main operation and can be treated if they cause a problem. Little flare veins are often best covered with skin makeup. Overall the chance of you developing new varicose veins in the next 10 years may be as high as 50%. Useful contact numbers NHS Direct Telephone Patient Services Telephone Health Info Telephone Stop Smoking Service Telephone A&E Telephone For GP out of hours, contact your surgery Useful websites If you require this document in another language, large print, braille or audio version, please contact Patient Information on Produced by Mr Cooper, September Revised April 2008, September 2010 by Dr K Russon & Mr Cooper, May 2012 Revision due May Version: 4.0. The Rotherham NHS Foundation Trust All rights reserved. 10

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