Prophylaxis of complications in venous surgery

Summary

Aim: The purpose of this article is to underline complications in venous surgery during the past 30 years and new ones arising with the introduction of technologies. We also discuss the “natural reduction” of some of these and how to prevent complications.

Methods: We have analysed different types of studies on different surgical procedures in the treatment of varicose veins and compared them with own outcomes.

Results: Considering all techniques, we have wound infections in 2,3–4 % of cases, cellulitis in 2,6–16 %, lymphatic complications in 1,3–60 %, pain in 2–23 %, neurologic disease including nerve damages, bruising and numbness in 0–50 %, thrombophlebitis in 0,3–20 %, deep vein thrombosis with or without pulmonary embolism in 0–5,7 %, injury of major vessel in 0,17 %, haematoma in 1,3–31 %, oedema in <1–15 %, hyperpigmentation in 3–11 %, ecchymosis in 0,8–9 %, skin burns in 0,2–8 %, erythema in 2–33 % and endothermal heat-induced-thrombosis (HEIT) in 0–7,5 % of cases.

Conclusion: Our outcomes confirmed literature results. We conclude that new technologies improve results and reduce complications, as do tumescent anaesthesia, medical stockings, early mobilization and low weight heparin prophylaxis (LMWH) in high risk patients.

Zusammenfassung

Ziel: Es sollen die Komplikationen der Varizenchirurgie der letzten 30 Jahre und die der neuen Technologien erörtert werden, besonders in Bezug auf den Effekt der “natürli-chen” Reduktion derselben durch neue Methoden.

Methode: Es wurden verschiedene Studien zu unterschiedlichen chirurgischen Techniken zur Behandlung von Varizen analysiert.

Ergebnisse: In dieser Analyse fanden wir folgende Komplikationen: Wundinfektionen in 2,3–4 % der Fälle, Zellulitis in 2,6–1,6 %, Lymphkomplikationen in 1,3–60 %, Schmerzen in 2–23 %, neurologische Komplikationen mit Nervenläsionen und Parästhesien in 0–50 %, Thrombophlebitis in 0,3–20 %, tiefe Venenthrombosen mit oder ohne Pulmonalembolie in 0,5–7 %, Verletzungen größerer Gefäße in 0,17 %, Hämatome in 1,3–31 %, Ödeme in <1–15 %, Hyperpigmentationen in 3–11 %, Blutergüsse in 0,8–9 %, Hautverbrennungen in 0,2–8 %, Erytheme in 2–33 % und EHIT in 0–7,5 % der Fälle.

Schlussfolgerung: Nach der Analyse der chirurgischen Vorgehensweisen bei Varikose können wir feststellen, dass die neuen Technologien die Resultate verbessern und Komplikationen reduzieren, wie auch die Tumeszenzanästhesie, Kompressionsstrümpfe, Frühmobilisation und fraktioniertes Heparin beim Hochrisikopatienten.

Keywords

Varicose vein surgery - prophylaxis in varicose vein surgery - postoperative complications

Schlüsselwörter

Varizenchirurgie - Vorbeugung in der Varizenchirurgie - postoperative Komplikationen

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