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Table of Content

• Abstract
• Evidences and studies
• Value and preferences in decision making for the tools
• Implementation of the evidence
• Preventive measures
• Problems and interventions
• Potential Barriers
• Conclusion
• References

Abstract:

The following report identifies various compression methods used for the post operative limb compression for the patients who undertook the vein varicose surgeries. The report explores the possible surgical and compression methods highly used and suitable for the treatment. The report also signifies the advantages and problems concerned with the treatment methods and the guidance regarding how the treatment can be used more effectively to provide better results and outcomes.

The report also focuses on the most used methods describing the reason for a high preference of such methods and the harming factors of the other methods that are not used widely by the health care professionals. Also the aspects that can be considered by the health care centers and the government for improving the treatment facilities and efficiencies are covered. The importance of the societal and family support is considered.

Evidences and Study:

This segment of the report identifies the study and evidences from various researches and journals regarding the number of compression methods that are proved highly beneficial and effective for the post operative limb compression patients.  It has been witnessed that the high compression method has been widely used by the health care experts. This method operates by applying high compression adhesive bandage to the limbs and applying non adhesive bandages on the contra lateral control limbs (Van et al, 2000).

The ICC that is International Compression Club is a group of experts of doctors and clinicians who are engaged in the management of the venous patients. This group conducted various studies and stated the issues regarding experimental finding regarding relevant compression therapy effects and the different clinical traits signifying the use of compression therapies. As per the study conducted by the group, a variety of different compression garments are used to for compressing the veins. These preferences differ from place to place. The compression applied to the limb through stockings is evaluated by analysis of the properties of the stockings. Several bandages were adopted to provide more effective results to the patients (Spence &  Cahall, 1996).

A Velcro band device provides faster healing than the four or three layer bands while elastic bands are also preferred for faster healing and cure Also t is witnessed that the intermittent pneumatic compression IPC boots are highly used for preventing the venous thromboses and complexities caused by venous. While the usage of the compression tools like hosiery, surgeries, laser ablations, treatment by radio frequency etc has been increased for effective and fast healing. Also the coban compression system used for the surgeries has been used widely for treating the patients (Partsch, 2003).

Value and preferences in decision making for the tools:

Various people have different preferences and choices regarding the materials or methods to treat the post operative limb compressions. The decision depends on various factors like the intensity of the pain, the age, sex, duration of suffering, cost and expenditures etc. Also the intensity of the disease is a major aspect through which the proper tool or compression method can be applied to the patients. There are various different stockings, wraps, belts and bandages used for different age groups and variety of disease (Morris & Woodcock, 2004).

The purchase preference of the patients mostly depends on the prescription of the doctors. The treatments are followed by the recommendations of the clinicians. The clinicians prescribe the different methods for the patients by analyzing the overall effect of pain and recovery chances. Thus the value and preferences of the patients for adopting methods for cure of post operative limb compression differs on various aspects such as disease, intensity or effects of the disease, cost etc (Jünger et al,  ,2004).

Implementation of the evidence:

Considering the surgeries, the surgical obliteration of varicose veins is widely adopted for cosmetic reasons also. The non cosmetic indications shows the symptomatic varicosities that is pain , nausea, fatigue, heaviness, bleeding etc of for the cure o venous hypertension after the skin or tissues such as lipoderma, ulceration etc have developed. The traditional approach for stockings and external pressure and compression is also a widely considered method as a substitute to the surgical methods. The disadvantages of degraded cutaneous symptoms though provide warrant intervention. Also the patient’s wishing to select the surgical treatments or the cosmetic treatments are possible indicators for the surgical treatments (Jonker et al, 2001).

For the patients who cannot maintain certain energy levels and stay active enough to decrease the risks of postoperative deep vein thrombosis must not intake surgical treatments. Also surgery while pregnancy must be avoided as many varicose veins concerning pregnancy regress after delivery of the child.  The surgeries for varicose veins has been evolving with new techniques since more than 2000 years while very little preference is given to cosmetic treatments. There are several measures taken to improve the quality of the treatments while providing more efficient results and speedier recovery. The main aim to use these therapies is to remove the superficial venous system through surgeries or ablations (Galili et al, 2007).

It is stated that the implementation of removal of the Great Saphenous Vein GSV can cure the venous hypertension caused by superficial and perforator vein reflux. Also if severe venous complexity is found, just the treatments regarding GSV are not sufficient. Some additional interventions with different surgeries and ablations are needed.  One of the method implemented among the patients are the open techniques. The Rindfleisch-Friedel process was developed in 1990s which suggested wrapping the deep fascia over the leg for six times. This treaties spiral gutter that witnessed large veins each one liggated. Also the Linton process id used highly for linear middle leg inclination that shows up all the perforator veins of the leg.  If we consider the laser therapies, laser fibers generate endoluminal heat that is used to destroy the vascular endothelium and is implemented using the Seldinger technique (Gniadecka et al, 2002).

The implementation of the method is done by passing the laser beams through the catheter by approximately 2cm. A local anesthetic is injected under ultrasonic sound and tumescent solution. This helps to eliminate the damaging structures like nerves and skin and its is also used for pain control. The radio frequency ablation method for varicose veins RFA is used under the radiofrequency thermal energy that is transferred directly to the vessel wall. This leads to protein providence, contractions and sudden closure of the vessels. It is noted that in comparison to high ligation and stripping methods, RFA or GSV takes more time to perform but the results of these methods are quite significant and the patients felt a high level of relief after undergoing these methods for treatment (Delis et al, 2001).

There are several other therapies like the Cutaneous electrodesiccation technique that uses electrical cautery for eliminating the small vessels. This method has high chances of injury and so is very rarely used nowadays. The other method that is Sclerotherapy is used to treat varicosities and reticular veins. This method has minimal risk factors and thus is accepted by the health care professionals. Nowadays, this method is used to treat the GSV and other disease and problems.This method includes injection of sclerosing substance into the abnormal or damaged vessels to generate endothelial destruction. This treatment fails if the high points of reflux is not found and treated well. The patient appears to be normal but the effects and recurrences of the problems and complexities would be witnessed very soon. While using this method, a high caution and care is exercised in the use of the sclerosing tools.  This methods and agents are used as they are very less harmful compared to the other methods and produce low allergic infections, low adverse effects, lesser staining etc (Delis et al, 2000).

Preventive measures:

After the patient undergoes the varicose treatment by the use of any method, a 30-40 mm Hg compression stocking is wrapped around the patients while the patients are advised to maintain or fasten their regular activities for a faster healing. Other health care experts also suggest the use of gradient compression stocking post the treatment of spider veins and small veins. It is stated that compression stockings for around 24 hours along with the thromboembolus deterrent stockings for the other 14 days have given the results similar to the compression bandaging of 5 days. In Also by the study conducted for the patients undergoing foam sclerotherapy for primary varicose veins, there was no significant difference resulted in vein occlusion, skin disorder or discoloration or pain. The ace wraps long stretched bandages are suggested as not to be used as the elastic bandages fail to balance and maintain the needed compression for some hours. These bandages often slip down and are misapplied or used by the patients. This can lead to tourniquet effects that can result into distal selling and increase risks of pain and infections (Benigni et al, 2003).

Problems and interventions :

It is witnessed that the proper and accurate treatment is needed for the varicose veins. The veins should be treated only if they are compatible and a primary and normal collateral pathway is found. Elimination of a saphneous vein with a system of termination will not help in the treatment of the nontruncal tributary varices (Calne & Moffat, 2003).

There are several complications caused by the dysesthesia are many.  This method may cause damage to the saphneous nerves. If the treatment is to be used several precautions are taken for prevailing the possible risk and damages. This can be done with using warm compress and anti-inflammatory drugs and aspiration where recommended (Benigni et al, 2003).

There are several other complications such as postoperative infections and reactions, arterial injuries, bleeding etc that can be managed by taking care while using the described methods for treatments and selecting the relevant and proper technique to treat the desired pain. Strict monitoring of the patient and the treatments should be to avoid consequences that have adverse effects (Benigni et al, 2003).

Also it has been signified that the treatments that incur laser therapy or the radiofrequency techniques are quite useful but also they apply high level of heat towards the tissues. Excessive heating of the tissues is highly risky for the tissues and can cause skin burns. However these side effects can be removed by using sufficient and needed volume of tumescent anesthetic. These anesthetic is injected into the damaged vessels and are injected to elevate or separate the skin from the veins. Thus the effects of the treatments or therapies could avoid the damage to the tissues (Calne & Moffatt, 2003).

The other factors that needs to be considered by the patients post the surgeries is to take prescribed medicines and drugs to avoid any other abnormalities and side effects of the surgery.

These methodologies adopted for the surgeries and post operation compression must be used as per suggested by the health care experts of the clinicians. There are various side effects that can damage the operated parts and create more painful situations. In this case the preventive measures and the post operative advices and suggestions must be considered by the patients and the family.  The family members can be highly supportive for the patients after the surgeries and during the treatment process. Proper cars can lead to better and faster healing for the patients along with the care and nurturing provided by the family members (Vayssairat et al, 2000).

Considering the role of the society, communities and the government in this health related problems, there can be made various contribution in order to help the patients emotionally, financially and with all the aspects where they would need help and care. There are several hospitals and care centers that provide reasonable and cheaper services to the patients suffering from the vein and varicose problems. The health care experts can provide proper diagnosis and treatments by visiting such hospitals (Delis et al, 2000).

The government can consider providing funding to such health care centers that provide cheaper treatments to the patients. Also the government can consider developing such institutes like the Varicose Vein forums for the treatment of the patients. This would help the patients get a better quality treatment with financial security. The health care canters may hire the professionals for treating the patients in a better way. Also several seminars can be considered for spreading the awareness regarding the disease and the possible options that are available for the treatments.

 There are several centers where the help regarding the treatments is provided. These centers provide diagnosis and treatment for the patients.

Also they focus on providing correct and relevant information regarding the treatment options.  There are professionals to help the patients diagnose the problems efficiently. After the diagnosis the professionals can prove guidance and information regarding the available options for the treatment. The proper methodology and surgical option has to be selected considering the intensity and type of problem or complexities.  The centers provide treatment options using various tools and equipments and do provide the post operative suggestions for avoiding the risks for any side effects. The family members also play a very important role in the treatment and while providing the moral support for the patients undergoing a huge trauma of the treatment (Grieveson, 2003).

Also there are post operation measures that have to be taken care of for avoiding the potential risk of side effects and reactions. The proper care of the diet, the activities performed in the routine, the medicines and drugs etc should be taken care of to heal the complexities as soon as possible. These surgeries are highly sensitive and require extreme care and nurturing. If there are any problems caused after the surgeries and before the healing, it can lead to dangerous consequences. In this case, regular visits to the doctors regarding the healing and the progress should be undertaken (Clarke et al, 1991).

The government must undergo several previous statistics and analysis to identify the previous and current number or population affected by the problems. Also the treatment techniques and the outcomes must be analyzed to identify the best possible solutions and the new advancements in the medical technologies to improve the treatment process. Also the statistics must be identified regarding the number of health care units established for providing the treatments and the number of people requiring the treatments. This may give an idea of what should be done to improve the treatment methodologies and the efficiency towards better treatment (Calne et al, 2003).

Potential Barriers:

There are methods for the post operative limb compression which has been widely used by the clinicians but also these methods have some complexities and complications. There are several barriers for the implementation of these treatment operations that are as below:

• The compression methods can lead to various causes like fatigability, pain, recurrent superficial thrombophlebitis, heaviness, minor bleeding etc.
• The traditional treatments like compression with stockings can be used as an alternative of surgery but more aggravating findings and indications in spite of the different side effects need intervention.
• The patients having venous outflow obstruction must not have their varicosities ablated as they are signifying pathways that allow flow of blood around the obstruction.
• Also the surgery comes with a risk of postoperative deep vein thrombosis DVT.
• Compression by stockings or surgery both can cause immediate relapse of varicose veins of pregnancy and thus, implementation of these methods during pregnancy is not encouraged.
• Proper diagnosis of the superficial venous insufficiency is needed. The treatment shall be progressed only if normal pathways for blood flow exist. Else the treatment would not give the desired results.
• Dysesthesias from any injury or saphenous nerve is considered as a minor barrier of the venous surgery.
• Also the cause post operative infections, arterial injuries, tissue heating with skin burns etc.

Conclusion:

It has been seen that there are many possible compression techniques used for the treatment of the varicose vein post operation. But the best methodology can be high compression methods that use bandages for the cure. Also there are other possible options for the treatment such as the laser therapy, the radio frequency therapies etc. Along with the benefits or healing these techniques provide, there are several problems or complexities found in the treatment process. However there are other possible options that can be used for the treatments but with intense care and prevention. The overall care for the patient is very important before, during and after the treatment and surgeries (Benigni  et al, 2003).

Also the communities and government can help in developing the centers where diagnosis and treatments can be offered in an efficient manner along with economic and financial feasibility of the patients. The government must understand the need of such forums and health care caters and the need of proper diagnoses and awareness for the treatment and shall provide funding and resources for these surgeries and complexities. Various camps and events must be organized to make the population aware regarding the disease and problems and the steps to avoid such complexities. This would be beneficial in making the ratio of such problems and abnormalities affect the people (Abu-Own et al, 1994).

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