Day Case Unit/ Treatment Centre Varicose Veins What are varicose veins? When the superficial veins in the leg become enlarged and distorted they are said to be varicosed. They are often found in people who need to stand for long periods at a time and where there is a family history. The operation consists of either division at the junction in the groin (high tie) or behind the knee where the superficial veins drain into the deep veins. In some cases the vein may be stripped and in many cases, segments of the vein above and below the knee will be tied off or pulled out (phlebectomies). This is done under a general anaesthetic. Alternative options for treatment These should have been discussed with you by your surgeon, when you were seen in the outpatients department at your initial consultation. If this was not the case, please ask for further information. Preparation required before surgery On the day of your operation please shave the leg, which is going to be operated on, including the groin area and have a bath or shower. The nurse looking after you will check your shave prior to the operation. You need to bring loose fitting clothes to wear home, e.g. shorts / skirt / jogging trousers, as the dressings on your leg may be bulky. Please wear flat supportive shoes to travel home. What will happen when you arrive on the unit? The surgeon will ask you to sign a consent form for the operation, and will mark the leg which is to be operated on. The anaesthetist (a doctor who sends you off to sleep and helps with pain control) will ask you some questions about your general health. You may be given graduated compression stockings to wear on your legs prior to the operation to prevent a deep vein thrombosis (DVT). If you need this information in another format or language please telephone 01536 492510 Further information about the Trust is available on the following websites: KGH - www.kgh.nhs.uk NHS Choices - www.nhs.uk Ref: PI 050 March 2017 Next review: December 2018
Following surgery You must stay in bed for at least two hours. You will gradually be allowed to sit up and then offered something to eat and drink. You may experience some pain or discomfort following the surgery. If so, please inform the nurse who will offer you pain relief medication. Before you are discharged, you will be encouraged to walk a short distance with a nurse to observe for post surgery bleeding, which is fairly common with this procedure. The nurse will change the dressings if necessary. You will stay in hospital for a minimum of two to four hours following the operation. Going home You must be taken home in a car or taxi and be accompanied by a responsible adult (18 years or over). It is also advisable that you have a responsible adult who will stay with you for 24 hours following surgery. It is anticipated that your length of stay will be approximately half a day. Please ensure that once you are ready, the person who is coming to collect you is prompt as you need to rest and your recovery will be more comfortable at home. Please give the Carer s Leaflet to the person collecting you and the person who will be staying with you. What are the risks? After varicose vein surgery there is often bruising under the skin. This will be worst in the first 10 days, but should subside in approximately six weeks. There is a small risk of bleeding from the wound sites. This risk may be reduced if you rest with your leg elevated on the day of the operation. Small patches of numbness, burning or altered skin sensation is common. This is unavoidable when veins are operated on and is due to injury to small nerves. Patients who have successful vein surgery may develop recurrent varicose veins. The operation will not necessarily eliminate all visible varicose veins. There is a slight risk of the wound becoming infected. If the wound becomes red, hot to the touch, painful, swollen, or you feel unwell, you must seek medical advice. There is a risk of blood clots forming in your legs (deep vein thrombosis). This risk is reduced by you wearing the graduated compression stockings as instructed. Risks related to a general anaesthetic are summarised in the leaflet You and your anaesthetic. - 2 -
What are the benefits? The aim of this operation is to reduce the discomfort in your legs and also to reduce the risk of leg ulcers. There may be some improvement in the appearance of your legs. Post surgery instructions After you get home from hospital, you need to rest completely with your feet up for the rest of the day. The day after your operation you may start to get up and gently walk about, increasing your activities, as you feel able. Walking is encouraged up to your normal level. It is important to rest in between activity with your feet elevated. You may experience pain or discomfort. It is advisable to take the pain relief medication provided regularly. Do not exceed the recommended dose as written on the packet. Keep the wound dressings clean, dry and intact, until the day after your operation when the district nurse will visit you. The nurse will remove the bandages, assess the wounds and help you to apply the graduated compression stocking(s). These stockings must be left in place for that day and overnight, and after that they should be worn for a further two weeks during the day (removing them when you go to bed). Groin wound. If you have stitches in the groin area, these are usually dissolvable. They will dissolve within three to six weeks. Keep the dressings clean and dry for two days. If the stitches are non - dissolvable, they need to be kept clean and dry until they are removed in 7 to 10 days at your GP surgery. You will need to arrange the appointment. Leg wounds. The stitches or steristrips (surgical sellotape) on the leg wounds will need to be removed after 4 or 5 days at your GP surgery. You will need to arrange the appointment. If you are happy to remove these yourself, you may do so. If the area around the stitches or steristrips becomes red, painful or hot to the touch please see GP or practice nurse for advice. You should avoid driving for a minimum of 10 days. Before driving again please ensure that you feel competent and safe to drive and are able to perform an emergency stop. You should check with your motor insurance company before resuming driving, as some policies do not cover their clients for a certain length of time following surgery. Usually you will be back to your normal level of activity by approximately two to three weeks. - 3 -
Contact Information If you have any queries or worries, please contact the Day Case Unit 8am 5pm Monday to Friday 01536 493680 Outside of these hours please contact your GP. For further information, please see: www.vascularsociety.org.uk - 4 -
Treatment Centre Please follow the fasting instructions in your appointment letter and bring this information leaflet on the day of your operation On the day of your operation, please bring: THIS INFORMATION PACK Contact telephone number for a lift home Dressing gown and slippers Something to read or to pass the time All medication in original containers Please do not: Chew gum on the morning of your operation Bring any valuables Wear face make-up or lipstick Wear any nail varnish or false nails Wear jewellery If you have any worries or queries prior to your procedure please contact: Pre-assessment on 01536 492867 Day Case Ward on 01536 493680 Geddington Ward on 01536 491313 Monday to Friday 9am to 12 midday Monday to Friday 8am to 5pm Monday to Friday 24 hours and Saturday mornings Information checked and adjusted by: Date: - 5 -
Instructions for patients who have had a General Anaesthetic Anaesthetic drugs may remain in the body for 24 hours gradually wearing off over this time. During the 24 hours following your anaesthetic you are under the influence of these drugs, therefore it is very important to follow these instructions: You must be taken home in a car or taxi and accompanied by a responsible adult (18 years or over). You should also have a responsible adult who will stay with you for the next 24 hours following surgery. Take things easy the day after your operation and do not participate in any strenuous exercise. Do not operate machinery and avoid using appliances such as cookers and kettles. Avoid alcohol. Be aware that smoking may cause you to feel sick and dizzy. It is advisable not to lock the bathroom or toilet door, or to make yourself inaccessible to the person looking after you in any other way. Drink plenty of fluids (at least 2 litres per day) and avoid heavy or greasy foods. You may return to your normal diet gradually as you feel able. Do not make important decisions. Do not sign important or legal documents for 48 hours. You should not be caring for young children alone. Do not drive for 48 hours following your general anaesthetic, or longer depending upon the site of the surgery. You are advised to avoid long distance journeys (3 hours or more) by any means of transport for the 4 weeks before or after your operation. If your travel is covered by insurance, you should inform your insurance company of the nature of your operation. Some people may feel slightly nauseous, tired or light-headed following a general anaesthetic but this should wear off after a few days. - 6 -