By Mitchel P. Goldman, Mihael Georgiev, Stefano Ricci
The single textual content in particular dedicated to the topic, this moment variation serves as an entire and functional advisor for office-based surgical operation of varicose veins-providing a number of illustrations showcasing the anatomy of varicose veins, in addition to step by step assurance of the ambulatory phlebectomy strategy.
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Additional info for Ambulatory Phlebectomy, Second Edition (Basic and Clinical Dermatology)
A firm post-operative compression, followed by immediate ambulation (possible only with tumescent anesthesia) avoids hematomas, thromboses, bleeding, infections. New adhesive acrylic bands, that may be placed directly over the skin, avoid many cutaneous problems associated with tight bandaging (blisters and abrasions). Keeping graduated elastic compression for 2 months improves the cosmetic result in some patients. DUPLEX EVALUATION During 1960s, when the Doppler was still to come into use, it was enough for the patient to be “Muller positive” (visible varicose veins, deep vein potency) to have an indication for surgery.
In conclusion, we can credit Home (1799) with the basic idea, Rima with the comprehension of valvular incompetence with a cavo-iliac-femoro-saphenous reflux and its practical application (1836), Brodie the description of the clinical test (1846), and Trendelenburg the skill in scientific divulgation and the diffuse therapeutic application (1890). A nationalist vision of these primacies always inspired history writers. Consequently, it is possible that on this subject some other author could raise a compatriot contribution, and so on.
The cauterization is preferred when the vein is straight; we should have recourse to it also if, in spite of the present obliquities, the vein is isolated and has a medium volume. At the opposite, if the varices are winding, at the point of forming a kind of circumvolutions and plaits, it is more advisable to excise them (utilius est eximere). Here is the way of making cauterization: teguments are incised and after the vein has been dissected, this is moderately touched by a red-hot iron with a thin and blunt tip.