Summary
Aim: After sclerotherapy of varicosities, eccentric compression is meant to provide
rapid and symptom-free vein regression. We evaluated a new compression modality consisting
of thin adhesive films and ultrasound transparent silicone gels, individually applied
along treated veins.
Methods: 120 patients were included with 148 superficial varicosities of 5.1–13.7
mm in diameter (mean: 7.6) undergoing foam sclerotherapy (Aethoxysklerol 1 %, filtrated
room air; ratio: 1+4). Postinterventional treatment was randomized to A) silicone
gel pad (SGP, Venartis® Inc.) on one half of the vein length for 2 weeks plus compression stocking (German
class 2) for 4 weeks, or B) compression stocking alone. The SGP consists of a thin
adhesive film sheet to serve as a mechanical skin protection, silicone gels with final
hardness of Shore-A 5–22 applied on the film from cartridges along the vein following
all curves, and a second adhesive film sheet to cover the silicone. Patients were
allowed to take daily showers with SGP in place. Vein diameters were measured by ultrasound
and clinical criteria determined after 2, 4 and 8 weeks.
Results: Vein segments receiving focal compression with SGP showed a faster regression:
52.5 % (22.4–74.2 %) vs. 23.1 % (8.1–36.7 %) after 2 weeks, 48.4 % (33.2–64.5 %) vs.
28.9 % (26.1–43.1 %) after 4 weeks and 66.7 % (31.1–82.4 %) vs. 39.2 % (21.0–61.8
%) after 8 weeks. The frequency of inflammatory reactions was lower when using SGP
(12.4 vs. 39.9 %). The frequency of mini-thrombectomies was lowered to 8.1 % with
SGP, versus 29.7 % in non-SGP segments, and oral analgetics were given in just 6.8
% (vs. 19.6 %). Discolorations were observed at week 8 in 10.8 % of the cases, vs.
35.1 % when using concentric compression only. Unwanted side effects of SGP were marginal
skin irritations (10.1 %), leading to a wearing time of 5–12 days in 2.0 % of the
cases (3/148). There were no other adverse reactions, in particular no allergies.
Conclusion: Venartis® SGP is a safe, effective and comfortable modality to support vein regression after
sclerotherapy of varicosities. The indications for hard and soft silicones, the dosage
in relation to vein diameter and position, wearing times and external pressure have
to undergo further studies. As the device is ultra-sound transparent, examinations
of treated veins will be possible with the pad in place to optimize the degree of
vein compression.
Keywords
Compression - silicone gel - gel pad - foam sclerotherapy - analgetics
