This information is in addition to the detailed patient information personally provided by Mr Ponosh
Please refer to to the Royal Australasian College of Surgeons Vein brochure also provided
Varicose veins are dilated and tortuous superficial skin veins. This results from increased pressure in the venous system arising from the main draining veins in the leg not functioning properly. For a variety of reasons including gender, family history, childbirth, prior deep vein thrombosis and a number of other factors, the valves in these draining veins fail causing blood to pool and increased back pressure. This causes the skin veins to dilate and become varicose.
A common treatment for varicose veins is contemporary open varicose vein surgery. This consists of ligating (tying off) the draining veins in the groin and/or behind knee through a 2-3 cm incision and removing the draining vein to the knee. A number of small avulsion incisions (1-2mm) are then made over the varicose veins to “tease them out”. This is usually conducted under a general anaesthetic at St John of God Subiaco or Hollywood Private Hospital with one nights stay.
Another method often utilised is radiofrequency ablation (RFA). This involves a more minimally invasive technique in which a catheter passed through the non-functional draining vein under ultrasound guidance. The catheter delivers thermal energy to the vessel wall causing it to contract and collapse. This is conducted under local anaesthetic in the rooms as an “walk in-walk out procedure”. Additional injection sclerotherapy may be required.
The procedure will take approximately 1 hour, although the duration of attendance varies. Both techniques are widely used, low risk and have very similar long term outcomes and durability. Mr Ponosh will discuss the best option for you.
Anaesthetic Complications: Are extremely low with modern techniques. Your specialist anaesthetist will discuss options and risks with you at length.
Deep Vein Thrombosis (DVT): Is a very rare complication manifested as significant pain and swelling. This risk is reduced by techniques in hospital as well as maintaining mobility and your stockings
Please advise us if you have a personal or family history of DVT.
RFA can not be conducted within 4 weeks of long haul flights.
Bruising: There is usually bruising along the vein that was stripped, this should resolve over 3-6 weeks.
Bleeding: Blood loss during varicose vein surgery is usually minimal.
Infection: This is rare and can be treated with a short course of oral antibiotics.
Groin haematoma: This is a clotted bruise in the groin and usually dissolves over time.
Leg swelling: This is common post surgery due to the interference with the lymph drainage system in the leg. This will settle with leg elevation, wearing your stockings and walking.
Nerve injury: During the surgery small veins that supply the skin surface can be damaged. This can cause numbness and tingling in the skin. This usually resolves within 6 months.
Scarring: The incisions are only small so scarring will be minimal within 3 months.
Recurrence: New varicose veins can develop and therefore it may be necessary to have further surgery in the future.
Cosmetic Issues: Whilst your leg will be dramatically improved by vein intervention, it is impossible to achieve perfection. Some additional sclerotherapy or topical laser may be required in the future.
To relieve pain, take simple analgesics such a regular paracetamol
Compression stockings: A form will have been provided to you by the rooms to obtain these stockings PRIOR to your procedure ONLY from the recommended supplier.
To be worn: Continuously for 5 days
Not to be removed for bathing/showering (Hospital Nursing staff will provide advice for bathing options)
Then during the day for 2 weeks
Contact Mr Ponosh’s Rooms or see your GP if you have:
Remove groin dressing on day 3 after operation.
The steri-strips (paper strip dressings) will slowly fall off 7-10 days after operation. You can shower over them and pat dry.
Monitor for signs of infection including redness, swelling, pus and heat. See your GP if these symptoms develop.
No routine follow-up review in the rooms will be arranged. A letter will be sent to your GP and/or referring doctor advising them of your management. If any concerns arise or you would like to see Mr Ponosh please contact the rooms on 9386 6200 and we will see you as clinically indicated.
Some small residual varicose or spider veins may persist. If these concern you please contact Mr Ponosh’s rooms 8-12 weeks following your surgery to discuss additional management options.
If you require treatment of veins on your other leg, please contact Mr Ponosh’s rooms to organize further management.
Please contact Mr Ponosh’s rooms on 9386 6200 or email admin@ponoshvascular.com.au to discuss and queries or questions.
