Saphenion®: Vacuum compression after varicose therapy – Introduction:
Saphenion®: Vacuum compression after varicose therapy – A vacuum-compression therapy after varicosis therapy is not yet standard. In some cases, it is applied again and again after radical surgical or thermal op techniques. According to our experience from 36 years of radical surgery in the context of vascular surgery and after 22 years of work with thermal ablation (laser, radio wave), this immediate postoperative vacuum-compression massage is not tolerated by the patient due to pain. We have other experiences after non-permanent, non-tumescent procedures, such as the vein glue or the sealing foam method. Here is a very good tolerance of the postoperative vacuum-compression experience. First of all, we want to present our first impressions and experiences with this new post-surgical adjuvant therapy of CVI. For a subjective and objective scientific analysis, we have started a prospective randomized study on this topic. This currently at this moment includes 507 patients.
Saphenion®: Vacuum compression after varicose therapy – Pathophysiological considerations
An inflammatory reaction is the complex response of the vascular and connective tissue to cell damage or destruction to eliminate the cause of the irritation and repair the defects that have arisen. The general treatment goals of vacuum compression are the reduction of tissue tension through the reduction of oedemas, the accelerated removal of cellular debris and inflammatory mediators, the reduction of postoperative pain, as well as the attenuation of an excessive inflammatory response. In the early phase after surgical interventions, the use of manual lymphatic drainage (ML) or even better the 12-chamber massage therapy has proven itself. These massage techniques promote the regeneration of lymph collectors in the injured area. Tissue scarring then feels softer, more resilient, and less likely to cause secondary mobility limitations. The postoperative extrinsic and muscular-like appearance is much less called by the patient. In begin of 2020, we changed to vacuum compression, in therapeutic relation to oxygen multistep therapy.
Saphenion®: Vacuum-compression after varicose therapy – Results
Saphenion®: Vacuum compression after varicose therapy – immediately after VenaSeal – vein glue or Sealing Foam is by now in Saphenion® Rostock standard in the after-treatment therapy. Over 4 years ago, we started to perform a vacuum compression of the treated legs in all patients immediately after varicose vein therapy using a vein glue or after a micro-foam therapy with Sealing Foam (sealing microfoam).
All patients gladly accepted this massage therapy of the operated legs by means of vacuum compression and in most cases also in combination with oxygen multistep therapy!
In the meantime, this additional adjuvant therapy complex is regularly in demand. Our experiences with vacuum compression therapy after sealing varicose veins are consistently positive. We introduced the new supporting therapy concept more than 4 years ago in Rostock. So far, 507 patients have been postoperatively treated by sealing truncal varicose veins, and 987 patients after a micro-foam therapy period using vacuum compression therapy. We were very surprised by the success of the therapy. All 507 VenaSeal patients showed significantly less hardening along the treated vein, the venous cord sensation was not noticed or was noticeably less prominent after the treatment. The pain was not reported at all. The real goal, the reduction of postoperative edema, was very impressive. None of the patients reported any swelling or heaviness – on the contrary, significantly lighter legs with significantly reduced swelling of the lower leg were already reported on the first postoperative day. The micro-foam therapy patients also found the massage after the treatment very pleasant. Significantly lower post-therapeutic hardening after treatment of varicose side branches could be found here. We have seen a new development of spider veins after vacuum compression therapy only in a few cases. For the use of vacuum compression therapy after tumescent anesthesia laser and radio wave, we have no current experience – we have in these cases refrained from vacuum compression therapy. Radical surgical therapy procedures are no longer offered in the Rostock practice.
Anesthesia was not possible. Thus, the health insurance has agreed to a VenaSeal – surgery simultaneously on both legs – The photo shows the patient after the intervention in intermittent compression therapy….
Saphenion®: Vacuum compression after varicose therapy – Discussion
Let us briefly quote from the guidelines on vacuum compression therapy in Germany:
Vacuum compression therapy consists of the prophylactic and therapeutic use of pneumatic alternating thrusts for thromboembolic prophylaxis, decongestive therapy for edema diseases, improvement of arterial and venous blood flow with reduction of clinical symptoms and to promote wound healing … According to these guidelines, intermittent compression therapy is not included immediately after surgical rehabilitation of varicose truncal veins and varicose side branches. After extensive soft tissue defects, e.g. after radical varicose vein treatment (stripping) or even after extensive thermal irritation of the subcutaneous tissue as a result of laser or radio wave ablation, this therapy is rather contraindicated in terms of wound healing and also avoids postoperative pain conditions! The situation is different with non-tumescent, non-thermal, non-radical forms of therapy. These cases show excellent post-operative healing effects. Also, the objective healing criteria, such as lack of instinct, significantly reduced endovenous thrombus formation, and postoperative hematomas and edema are extremely positively influenced.
We will report on the 5-year results of our prospective single-center study and the subjective and objective results derived from it.
Saphenion®: Vacuum compression after varicose therapy – „Milosh Ilic“ – guest in Rostock
Photos / Video: Utzius
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