Chronic
venous insufficiency
This is when the poor flow of blood in the veins
interferes with the way the skin exchanges oxygen,
nutrients and waste products with the blood.
When this happens over an extended period of
time, venous insufficiency can cause a number
of problems including:
Varicose eczema
This is brown or purple discoloration of the skin
that often leads to a permanent staining.
Venous ulcers
These are a sign of very weak blood flow in the veins
that drain blood from the skin. A minor wound, usually
around the shin or ankle, can fail to heal, causing
an ulcer. Poorly treated, these ulcers can become
chronic, afflicting victims for years, even decades.
 Having
varicose veins does not mean that you will inevitably get
complications or venous insufficiency. And although they
won't usually get better without treatment, varicose veins
only get worse slowly.
Investigations
Varicose veins are easily visible. To work out
the position and extent of valve weakness, there
are a number of tests a doctor might do.
- A Doppler test uses ultrasound to give information about
blocked veins and the direction of blood flow in a vein.
- The Trendelenburg test involves lying down
and lifting one leg up in the air. The doctor
uses a hand or a tourniquet to temporarily block
off the blood flow in the veins. The patient
stands up and the refilling of the varicose veins
with blood gives an indication of which part
of the leg has faulty valves.
- A venogram is a test where a dye is injected
into a vein in the foot and radiographs (X-rays)
are taken of the outlined veins in the leg.
Treatments
 Compression
stockings
These may relieve the swelling and aching of the
legs but do not prevent more varicose veins from
developing. They are worn during the day and taken
off at night. Graduated compression stockings are
tightest at the ankle and get gradually looser further
up the leg. This helps to encourage the blood flow
up towards the heart.
Compression stockings are available in various
sizes and pressures and it is very important that
you get them to fit you properly. They are made
to fit the calf diameter not by foot size. Your
GP or pharmacist should be able to provide advice.
Some people find compression stockings difficult
to put on. There are tools available to help, or
you could ask for help from a partner or friend.
Stockings can be uncomfortable, especially in hot
weather. But there is no point in wearing them
rolled down.
Sclerotherapy
Small varicose veins can be injected with a chemical
that damages the vein walls. As a result, scar tissue
forms which closes off the affected vein. Other stronger
veins take over and the treated vein, no longer filled
with blood, becomes less visible.
For sclerotherapy to be successful, a compression
bandage has to be worn for between three and six
weeks after the treatment.
This treatment can be an alternative to surgery,
but it is does not guarantee that the varicose
veins will not reappear, or that other nearby veins
will become varicose. Often, several injections
are needed. One possible side-effect of this treatment
is skin discolouration.
Surgery
This involves removing the affected superficial veins.
There are many variations of operation, depending
on which veins need treatment. The most common is
called ligation and stripping.
Under a general anaesthetic, the vein to be treated
is tied off (ligated) at the top of the leg. A
flexible wire is passed through the affected vein
and attached to one end. By pulling the wire back,
the vein is "stripped"
out. A number of smaller cuts in the skin may be
made to remove smaller varicose veins at the point
where they were attached to the stripped vein.
Although removed veins cannot reoccur, other leg
veins could also become varicose.
New approaches
"Minimally-invasive" techniques such as
laser and microwave treatments are being studied
at some hospitals. One of these is endovenous ligation
treatment (EVLT), where a fine laser probe is passed
inside a vein, minimising damage to the skin.
NOTE:
Microcyn® does not have U.S. FDA clearance
for claims other than to moisten, lubricate,
cleanse and debride wounds. |
