Postoperative quality of life, satisfaction, and skin condition after varicose vein surgery

Summary

Background

Compression is performed postoperatively with the intention of minimising side effects, such as bleeding and haematoma in the area of operation, as well as postoperative oedema and pain. Compression stocking manufacturing has incorporated the addition of skin care products into the yarn material in recent years. However, the benefits of these products remain controversial. In addition, the length of the compression stocking is disputed in terms of its effectiveness. This effectiveness was investigated in the present study.

Method

Before surgery, 160 patients with indication of surgical removal of varicose veins were randomly divided into four groups with different types of compression stockings in each case. In each group, 40 patients received a knee-length stocking (length A–D), thigh-length stocking (length A–G), knee-length stocking with Aloe vera or thigh-length stocking with AV. At time 0 (before surgery), one week and 8 weeks after surgery, skin moisture was measured as an objective parameter, quality of life was determined using the Freiburger questionnaire of quality of life in veinous disease (FLQA-vs), benefit to patients was evaluated using the patient benefit index (PBI-v) and further subjective parameters were investigated with a free-text questionnaire. After surgery, the extent of haematoma was determined using the point count method.

Result

After surgery, at both post-operative times, the FLQA-vs decreased significantly (corresponding to a better quality of life), and the PBI-v increased. In the group with Aloe, pruritus was significantly lower, comfort and skin moisture were increased, and skin condition was significantly improved. The extent of haematoma decreased regardless of the length of the stockings.

Conclusion

A benefit of AV as a skin care additive was observed. This finding was objectively confirmed based on the skin moisture. The multifactorial quality of life was not affected by the skin care additive. Thigh-length compression stockings did not provide a measurable benefit.

Keywords

Compression therapy - care additives - quality of life - skin condition

• References

• 1 Sippel K, Jünger M. Compression treatment of varicose veins and chronic venous insufficiency. Principles and effectiveness. Gefässchirurgie 2006; 11: 203-216.
• 2 Partsch H, Flour M, Smith PC. et al. Indications for compression therapy in venous and lymphatic disease consensus based on experimental data and scientific evidence. Under the auspices of the IUP. Int Angiol 2008; 27: 193-219.
• 3 Wienert V, Waldermann F, Zabel M, Rabe E, Jünger M. Leitlinie der Deutschen Gesellschaft für Phlebologie: Medizinischer Kompressionstrumpf (MKS). Phlebologie 2004; 33: 139-144.
• 4 Wittens C, Davies AH, Bækgaard N. et al. Editor’s Choice – Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015; 49: 678-737.
• 5 Kluess HG, Noppeney T, Breu FX. et al. Leitlinie zur Diagnostik und Therapie der Krampfadenerkrankung. Phlebologie 2010; 39: 271-289.
• 6 Benkö T, Cooke EA, McNally MA. et al. Graduated compression stockings: knee length or thigh length. Clinical orthopedics and related research 2001; 383: 197-203.
• 7 Brady D, Raingruber B, Peterson J. et al. The use of knee-length versus thigh-length compression stockings and sequential compression devices. Critical care nursing quarterly 2007; 30: 255-262.
• 8 Courage W. Hardware and measuring principle: corneometer. CRC press 1994; 14: 171-175.
• 9 Schöpf E, Augustin M, Zschocke I. et al. Quality of life in chronic vein insufficiency: The Freiburg questionnaire for recording quality of life with vein disorders. Deutsches Ärzteblatt 1999; 96: 1971-1973.
• 10 Blome C, Augustin M, Heyer K. et al. Evaluation of patient-relevant outcomes of lymphedema and lipedema treatment: development and validation of a new benefit tool. Eur J Vasc Endovasc Surg 2014; 47: 100-107.
• 11 Mackenzie RK, Paisley A, Allan PL. et al. The effect of long saphenous vein stripping on quality of life. Eur J Vasc Endovasc Surg 2002; 35: 1197-1203.
• 12 Durkin MT, Turton EP, Wijesinghe LD. et al. Long saphenous vein stripping and quality of life – a randomized trial. Eur J Surg Vasc Endovasc Surg 2001; 21: 545-549.
• 13 Biswas S, Clark A, Shields DA. Randomised clinical trial of the duration of compression therapy after varicose vein surgery. Eur J Vasc Endovasc Surg 2007; 33: 631-637.
• 14 Noppeneny T, Nüllen H. Compression therapy after invasive measures in phlebology. Phlebologie 2011; 40: 15-19.
• 15 Reich-Schupke S, Murmann F, Altmeyer P. et al. Quality of life and patient’s view of compression therapy. Int Angiol 2009; 28: 385-393.
• 16 Sajid MS, Tai NRM, Goli G. et al. Knee versus thight length graduated compression stockings for prevention of deep venous thrombosis: a systematic review. Eur J Vasc Endovasc Surg 2006; 32: 730-736.
• 17 Ingram JE. A review of thight-length vs knee-length antiembolism stockings. Br J Nurs 2003; 12: 845-851.
• 18 West DP, Zhu YF. Evaluation of Aloe vera gel gloves in the treatment of dry skin associated with occupational exposure. Am J Infect Control 2003; 31: 40-42.
• 19 Surjushe A, Vasani R, Saple DG. Aloe vera: a short review. Indian J Dermatol 2008; 53: 163-166.
• 20 Hegner G, Wienert V, Sick H. et al. Skin moisture and age. Fortschr Med 1981; 99: 486-490.
• 21 Häfner HM, Voller B, Schlez A. et al. Moisture, temperature and pressure behaviour of various compression materials under strain on the treadmill in comparison to patients with healthy vessels. VASA 1999; 28: 229.
• 22 Jünger M. Influence of urea-retaining compression stockings on the barrier function of the skin in patients with venous insufficiency. Vasomed 2006; 18: 144-145.
• 23 Taute BM. Chronic venous insufficiency. Der Internist 2010; 51: 351-358.
• 24 Partsch B, Partsch H. Which pressure do we need to compress the great saphenous vein on the thight?. Dermatol Surg 2008; 34: 1726-1728.
• 25 Partsch H. New aspects of compression therapy. Hautnah 2012; 11: 12-13.
• 26 Rastel D, Perrin M, Guidicelli M. Compressive therapy after varicose vein surgery: results of a French national inquiry. J Mal Vasc 2004; 29: 27-34.