Rehabilitation after phlebectomy

It is important for every person who decides to have a vein removal operation to understand that proper recovery after a phlebectomy is no less important than the surgical intervention itself. This is due to the fact that varicose veins are just one of the manifestations of the disease. Removing these veins is certainly very important to improve the appearance of the legs. But surgery itself is only part of the healing process.

Tasks to be solved in the process of rehabilitation

The expansion of the saphenous veins of the legs and thighs is a manifestation of varicose veins, which occurs due to stagnation of blood in the vessels. It is promoted by a sedentary lifestyle, pregnancy, childbirth, overweight, bad habits, hard physical work, long standing, heredity.

Removal of veins does not eliminate the causes of the disease. It solves, first of all, the cosmetic problems of the patient. In addition, after phlebectomy, unpleasant symptoms (heaviness, numbness, pain) decrease, and the progression of the disease slows down. But if you do not follow the recommendations prescribed by the doctor, the manifestations of the disease may return, and already other veins will expand and appear under the skin.

In addition, complications (eg, inflammation of the postoperative wound, bleeding, suture divergence) may develop after phlebectomy. And the operation itself, as a strong stress factor, can lead to an exacerbation of chronic diseases. Therefore, when developing an individual rehabilitation plan, it is necessary to plan activities aimed at:

• to exclude complications during surgery and in the early postoperative period,
• prevention of exacerbation of chronic diseases,
• prevention of recurrence of the disease.

Various means are used to solve these problems. This is a regimen, and drugs, and physiotherapy exercises. Compliance with recommendations for lifestyle changes after phlebectomy plays a special role in the prevention of relapses.

Medical therapy before and after surgery

Varicose veins are usually the lot of middle-aged and elderly people. Some of them must take medications for comorbidities on an ongoing basis.

Some of the drugs must be taken especially carefully (for example, antihypertensives) in order to control the disease well before and after surgery. Others (this happens rarely) must be canceled for a few days. It happens that a patient with a predisposition to any complication is prescribed a short course of anti-relapse treatment (for example, Omez for peptic ulcer or Aspirin for a tendency to thrombosis).

The patient should solve these questions not independently, but with the participation of the surgeon, as well as the anesthesiologist. Sometimes, in order to receive such recommendations, it is necessary to consult a therapist or a doctor of a narrow specialty.

Of the drugs prescribed directly for varicose veins, we can mention venotonics, agents that strengthen the vascular wall, vitamins. Their use is recommended for a long time. Occasionally in the postoperative period there is a need for antibiotics (if there are signs of inflammation of the postoperative wound) or a short course of painkillers.

Motor activity in the postoperative period

The next thing to pay attention to is physical activity. The first hours after the operation, the patient is still under the influence of anesthesia and must comply with bed rest. But as soon as the action of the drugs ends, it is possible and necessary to expand motor activity. The first exercises from the complex of therapeutic exercises after phlebectomy are performed lying down. These may include the following exercises:

• rolling from back to stomach and vice versa;
• swinging the legs in the prone position;
• "scissors"
• "bike".

Early activation of the patient after phlebectomy is important for the prevention of blood clots in the veins. Sometimes they are formed due to prolonged forced immobility (in bedridden patients, after surgery). If such a thrombus breaks off, it can be transferred to other organs with the bloodstream, causing thromboembolism - a very serious complication.

The day after the operation, the patient is allowed to stand up. The exercise therapy complex after phlebectomy includes tilts, leg swings. The sutures are removed 7–14 days after the operation (depending on the extent of the intervention). A week after that, you can start doing squats, lunges and other exercises for the leg muscles.

After complete healing of postoperative wounds (about a month later), you can start regular physical education - walking, jogging, cycling, swimming. It is important that the muscles of the legs are regularly "included in the work." This helps to normalize blood circulation, improve venous outflow. At the same time, it must be remembered that with varicose veins, including after surgery, heavy physical exertion, sauna visits, and prolonged standing are contraindicated.

Dressings, bandaging with an elastic bandage and compression stockings

Despite the fact that modern phlebectomy is performed through small incisions, the volume of tissues that are injured is relatively large - this is the entire space under the skin along the course of the removed vein. Therefore, the risk of hematomas and bleeding is quite high.

To accelerate healing and prevent bleeding after surgery, tight bandaging of the legs with an elastic bandage is used. Bandaging also improves venous outflow from tissues, being the prevention of varicose veins. The bandage should be applied in the morning, without getting up in bed, from the bottom up. Instead of bandaging, compression underwear - socks or stockings - can be used.

The degree of compression immediately after surgery should be maximum. At the same time, the patient must wear bandages or underwear around the clock. After about a month, you can start wearing less compression underwear, and only during the day, taking it off at night. However, it is impossible to completely abandon tight-fitting golf or tights - patients should wear them for life, especially on those days when a heavy load on the legs is expected.

Lifestyle advice

As already mentioned, one of the factors in the development of varicose veins is overweight. Therefore, weight loss is an important point in rehabilitation. Nutrition after phlebectomy must be adjusted in such a way as to receive a sufficient amount of complete protein, cereals, vegetables and fruits. The amount of fat, especially animal, sugar and flour products, on the contrary, should be reduced.

Particular attention should be paid to vitamins and minerals. If it is impossible to draw up a complete diet, biologically active additives can be used to make up for the deficiency of essential substances.

Also very important in rehabilitation is the rejection of bad habits (smoking, alcohol abuse). In addition, some patients may need to change jobs (if it involves heavy physical exertion or long stay on their feet) or switch to light work.

In conclusion, it should be said that rehabilitation after phlebectomy is not a matter of a couple of days, or even a couple of weeks. It begins from the moment the patient is prepared for surgery, continues in the postoperative period and does not stop even after discharge from the hospital. Some recommendations aimed at preventing the development of relapse should be followed for life.

Recovery after phlebectomy - video