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

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

doi:10.1590/1677-5449.202200522

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Jornal Vascular Brasileiro

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ORIGINAL ARTICLE • J. Vasc. Bras. 22 • 2023 • https://doi.org/10.1590/1677-5449.202200522 copy

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

Authorship SCIMAGO INSTITUTIONS RANKINGS

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

Variable	Elastic compression group (n=32)	Conventional bandaging group (n=20)	p value
Female	31 (96.875%)	19 (95%)	0.6898^* * Chi-square test.
Male	1 (3.125%)	1 (5%)
Age – mean (SD)	44.31 (11.06)	48.20 (14.42)	0.2784^† † t test.
Standing
Yes	20 (62.5%)	12 (60%)	0.9103*
No	12	8 (40%)
Family history
Yes	25 (78.125%)	16 (80%)	0.8509*
No	7	4
Disease duration – median (IQR)	7.5 (5.0-10.0)	7.5 (2.5-10.0)	0.4518^‡ ‡ Mann-Whitney test.
Physical inactivity
Yes	25 (78.125%)	16 (50%)	0.8509*
No	7	4
Previous surgery
Yes	8 (25%)	4 (12.5%)	0.9378*
No	24	16
BMI – mean (SD)	26.71 (3.23)	27.54 (3.37)	0.3804^†
Number of pregnancies – median (IQR)	2 (1-2)	2 (1-2)	0.4780^‡
Comorbidities	8 (25%)	7 (35%)	0.6457*
Hypertension	2 (6.25%)	3 (15%)	0.5770*
Dyslipidemia	1 (3.125%)	1 (5%)	0.6898*
Depressive disorder	3 (9.375%)	2 (10%)	0.6825*
Anxiety disorder	1 (3.125%)	0 (0%)	0.8107*
Thyroid disease	1 (3.125%)	1 (5%)	0.6898*

Variable	Elastic compression group (n=32)	Conventional bandaging group (n=20)	p value
Pain – median (IQR)	1.0 (0-1)	1.5 (1-2)	0.0320^† † Mann-Whitney test.
Tightness – mean (SD)	1.75 (1.67)	1.50 (1.88)	0.6183^* * t test.
Tiredness – median (IQR)	1 (0-2.5)	1 (1-3)	0.6859^†
Burning – median (IQR)	0 (0-0.5)	0 (0-2.0)	0.2323^†
Edema – median (IQR)	1 (0-1)	0 (0-0.5)	0.1324^†
Discomfort – mean (SD)	3.66 (2.21)	2.80 (1.79)	0.1513*
Right limb volume variation – mean (SD)	10.33 (51.50)	-31.97 (108.59)	0.1159*
Left limb volume variation – mean (SD)	4.05 (35.97)	-53.44 (91.08)	0.0129*

Score	Elastic compression group (n=32)	Conventional bandaging group (n=20)	p value
Rater 1 – mean (SD)	2.27 (0.72)	2.74 (0.95)	0.0509^* * t test.
Rater 2 – mean (SD)	2.42 (0.93)	2.90 (0.90)	0.0744*

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[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.