Objective To explore the effect, operational essential, and clinical meaning of transilluminated powered phlebectomy for patients with varicose vein of the lower extremity. Methods In the study, 255 patients with 363 lower extremities of varicose vein in our hospital between May 2006 and November 2009 were treated by transilluminated powered phlebectomy. According to revised clinical etiology anatomic and pathophysiological classification system (CEAP), there were 104 limbs in C2, 53 limbs in C3, 155 limbs in C4, 34 limbs in C5, and 17 limbs in C6. The patients were followed up to observe postoperative complications. Results All varicose vein labeled before operation were resected. Surgical time was (100±20) min in unilateral lower extremity and (147±19) min in bilateral lower extremities. Total 221 patients (302 lower extremities) were followed up in 4 to 46 months, median follow up time was 24.5 months. Total 167 cases (247 lower extremities) had accepted the operation more than 1 year, 154 cases (229 lower extremities) in which were followed up. In the 229 lower extremities above, recurrences occurred in 11 extremities, small amounts of residual small varices were observed in 2 extremities, the recurrence rate was 5.68% （13/229）. Twenty-one limbs with ulcer were healing in 3 to 6 weeks after operation. Postoperative complications: there was paresthesias or pain of ankle area in 16 limbs, which was improved in 3 to 6 months after physical therapy; there was ecchymosis of skin of leg in 112 limbs, which disappeared in 3 to 5 weeks after operation; there was light edema in 37 limbs, which disappeared in 1 to 2 weeks after operation; there was local hematoma in 2 limbs, incision light infection in 5 limbs, skin and subcutaneous tissue necrosis above medial malleolus in one limb, and back of knee popliteal skin lesion in 2 limbs, which were all cured by the symptomatic treatment. Conclusions Surgical treatment of varicose veins is actually the combination of various surgical procedures. Varicose vein extraction using transilluminated powered phlebectomy is safe, efficacious, and cosmetically satisfactory.
Objective To compare scar and incision satisfaction between Prolene polypropylene suture and conventional silk suture for dermal suture in high ligation and stripping of primary great saphenous varicose vein. Methods A total of 83 patients who met the inclusion criteria were admitted in the West China Hospital, including 27 males and 56 females. The average age was 46.7 years old, ranging from 30 to 63 years old. Forty-two patients were grade C2 and 41 were grade C3 according to the CEAP grading. Patients were divided into a polypropylene suture group (even number,n=45) and a silk suture group (odd number,n=38) according to admission date order. Prolene 5-0 polypropylene suture was used for dermal suture in the patients of the polypropylene suture group and 1# silk suture in the patients of the silk suture group. The pigments of incision area and suture area and their widths, and the points of Patient and Observer Scar Assessment Scale score (POSAS) and patient and observer satisfaction score of incision were observed on month 6 for following-up. Results ① The gender, age, body mass index, and proportion of C2 of the CEAP grading or smoking had no significant difference between these two groups (P>0.05). ② All the operations were successful and all the patients were followed up. All the incisions healed well and had no infection. There was a few subcutaneous hematoma in one incisionof the 2 patients on day 3 after operation in the two groups, which markedly improved after dressing treatment. The sutures of all the patients were removed on day 14 after operation. ③ The pigment of incision area and its width, and the points of POSAS had no significant differences between the two groups (P>0.05). The pigment of suture area and its width, and the points of patient and observer satisfaction score of the incision in the polypropylene suture group were significantly better than those in the silk suture group (P<0.05). Conclusion Prolene polypropylene suture is preference to conventional silk suture in aesthetic results and patient satisfaction for dermal suture of great saphenous varicose vein surgery.