Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202200522
Jornal Vascular Brasileiro
Original Article

Influence of compression therapy following varicose vein surgery: a prospective randomized study

Influência da terapia compressiva no pós-operatório de flebectomia: um estudo prospectivo e randomizado

Felipe Coelho Neto; Walter Junior Boim Araújo; Sergio Belczak; Eduarda Ferreira Rui; Beatriz Begnini Borsato; Nathália Favaretto Baldesserra; Rodrigo Gomes de Oliveira

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Abstract

Abstract: Background: The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous.

Objectives: To evaluate compression therapy with elastic stockings for 7 days after phlebectomy.

Methods: We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) – wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) – given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume.

Results: Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls.

Conclusions: Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Keywords

venous insufficiency, varicose veins, compression stockings

Resumo

Resumo: Contexto: O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável.

Objetivos: Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia.

Métodos: Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) – uso de meia elástica por 24 horas após a cirurgia – e grupo controle (40 membros) – uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia.

Resultados: Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle.

Conclusões: O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.
 

Palavras-chave

insuficiência venosa, varizes, meias de compressão

References

1 Lurie F, Lal BK, Antignani PL, et al. Compression therapy after invasive treatment of superficial veins of the lower extremities: clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. J Vasc Surg Venous Lymphat Disord. 2019;7(1):17-28. http://dx.doi.org/10.1016/j.jvsv.2018.10.002. PMid:30554745.

2 Krasznai AG, Sigterman TA, Troquay S, et al. A randomised controlled trial comparing compression therapy after radiofrequency ablation for primary great saphenous vein incompetence. Phlebology. 2016;31(2):118-24. http://dx.doi.org/10.1177/0268355514568658. PMid:25616874.

3 Reich-Schupke S, Feldhaus F, Altmeyer P, Mumme A, Stücker M. Efficacy and comfort of medical compression stockings with low and moderate pressure six weeks after vein surgery. Phlebology. 2014;29(6):358-66. http://dx.doi.org/10.1177/0268355513484142. PMid:23563646.

4 Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study. J Vasc Surg. 2007;45(6):1212-6. http://dx.doi.org/10.1016/j.jvs.2007.02.039. PMid:17467226.

5 Lugli M, Cogo A, Guerzoni S, Petti A, Maleti O. Effects of eccentric compression by a crossed-tape technique after endovenous laser ablation of the great saphenous vein: a randomized study. Phlebology. 2009;24(4):151-6. http://dx.doi.org/10.1258/phleb.2008.008045. PMid:19620697.

6 Mosti G, Mattaliano V, Arleo S, Partsch H. Thigh compression after great saphenous surgery is more effective with high pressure. Int Angiol. 2009;28(4):274-80. PMid:19648870.

7 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(6):678-737. http://dx.doi.org/10.1016/j.ejvs.2015.02.007. PMid:25920631.

8 National Clinical Guideline Centre. Varicose veins in the legs: the diagnosis and management of varicose veins. London: National Institute for Health and Care Excellence; 2013.

9 Bond R, Whyman MR, Wilkins DC, Walker AJ, Ashley S. A randomised trial of different compression dressings following varicose vein surgery. Phlebology. 1999;14(1):9-11. http://dx.doi.org/10.1177/026835559901400103.

10 Elderman JH, Krasznai AG, Voogd AC, Hulsewé KW, Sikkink CJ. Role of compression stockings after endovenous laser therapy for primary varicosis. J Vasc Surg Venous Lymphat Disord. 2014;2(3):289-96. http://dx.doi.org/10.1016/j.jvsv.2014.01.003. PMid:26993388.

11 Houtermans-Auckel JP, van Rossum E, Teijink JA, et al. To wear or not to wear compression stockings after varicose vein stripping: a randomised controlled trial. Eur J Vasc Endovasc Surg. 2009;38(3):387-91. http://dx.doi.org/10.1016/j.ejvs.2009.05.025. PMid:19608438.

12 El-Sheikha J, Carradice D, Nandhra S, et al. Systematic review of compression following treatment for varicose veins. Br J Surg. 2015;102(7):719-25. http://dx.doi.org/10.1002/bjs.9788. PMid:25833417.

13 Benigni JP, Allaert FA, Desoutter P, Cohen-Solal G, Stalnikiewicz X. The efficiency of pain control using a thigh pad under the elastic stocking in patients following venous stripping: results of a case-control study. Perspect Vasc Surg Endovasc Ther. 2011;23(4):238-43. http://dx.doi.org/10.1177/1531003511431737. PMid:22237977.

14 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(5):631-7. http://dx.doi.org/10.1016/j.ejvs.2006.12.003. PMid:17276100.

15 Sukul DMK, Hoed PT, Johannes EJ, van Dolder R, Benda E. Direct and indirect methods for the quantification of leg volume: comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement. J Biomed Eng. 1993;15(6):477-80. http://dx.doi.org/10.1016/0141-5425(93)90062-4. PMid:8277752.

16 Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG. Telangiectasia in the Edinburgh Vein Study: epidemiology and association with trunk varices and symptoms. Eur J Vasc Endovasc Surg. 2008;36(6):719-24. http://dx.doi.org/10.1016/j.ejvs.2008.08.012. PMid:18848475.

17 Uhl JF, Benigni JP, Chahim M, Fréderic D. Prospective randomized controlled study of patient compliance in using a compression stocking: importance of recommendations of the practitioner as a factor for better compliance. Phlebology. 2018;33(1):36-43. http://dx.doi.org/10.1177/0268355516682886. PMid:27940899.

18 Rabe E, Partsch H, Hafner J, et al. Indications for medical compression stockings in venous and lymphatic disorders: an evidence-based consensus statement. Phlebology. 2018;33(3):163-84. http://dx.doi.org/10.1177/0268355516689631. PMid:28549402.

19 Bakker NA, Schieven LW, Bruins RM, van den Berg M, Hissink RJ. Compression stockings after endovenous laser ablation of the great saphenous vein: a prospective randomized controlled trial. Eur J Vasc Endovasc Surg. 2013;46(5):588-92. http://dx.doi.org/10.1016/j.ejvs.2013.08.001. PMid:24012465.

20 Ye K, Wang R, Qin J, et al. Post-operative benefit of compression therapy after endovenous laser ablation for uncomplicated varicose veins: a randomised clinical trial. Eur J Vasc Endovasc Surg. 2016;52(6):847-53. http://dx.doi.org/10.1016/j.ejvs.2016.09.005. PMid:27760697.

21 Ayo D, Blumberg SN, Rockman CR, et al. Compression versus no compression after endovenous ablation of the great saphenous vein: a randomized controlled trial. Ann Vasc Surg. 2017;38:72-7. http://dx.doi.org/10.1016/j.avsg.2016.08.008. PMid:27554689.

22 Al Shakarchi J, Wall M, Newman J, et al. The role of compression after endovenous ablation of varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(4):546-50. http://dx.doi.org/10.1016/j.jvsv.2018.01.021. PMid:29680439.
 


Submitted date:
04/24/2022

Accepted date:
04/04/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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