The present study was conducted with the aim to evaluate the clinical features and management of varicose veins in terms of recurrence and symptoms improvement.
Methodology: It was a prospective study; fifty cases of varicose veins were attending outpatient Department and admitted in the Surgical Department of Deccan College of Medical Sciences & Hospital from October 2018 to September 2019.
Results: In the present study, out of the 55 limbs examined and investigated, 7 limbs (12.72%) found to have suffered from deep vein thrombosis. Out of these 3 (5.4%) were found on clinical examination while investigations revealed deep vein thrombosis in 4 (7.2%) limbs. Routine investigations were carried out to evaluate patients’ fitness for surgery. Out of 50 patients 2 (5.5%) were unfit because of severe cardiac problem. The colour doppler study was done in all cases of which, in 12 cases (21.81%) an additional information was found. Out of these in two patient (16.66%) two perfortors missed on clinical examination was detected while in 6 patients (50%) additional information about perforator competency was found. Four patients have got additional information about deep vein patency. The accuracy of colour doppler in detecting SFJ and SPJ incompetence was 100%. By colour doppler, a total of 21 sites were marked as incompetent perforators, out of which 19 were found correct on exploration (90.47%specificity). Abdominal ultrasonography was performed in all patients. No abnormality was found in 49 of them while one had small left renal calculus. Various combinations of operations were carried out, according to the site of pathology determined by clinical examination and investigations. In our study, out of 55 limbs affected, only 14 limbs were operated upon. Out of 55 limbs, 41 were (74.54%) treated conservatively. Majority of them 29 were (64.1%) relieved of the symptoms by conservative method. From total 50 patients, 23 were treated on out Patients basis while 27 patients (46%) needed admission for either operative purpose or for ulcer healing. The average stay with 13 patients (45%) having ulcer was l5days. Stay was shorter in 14 patients (55%) who were not having ulcer, was average 11days. In the present study, only early post operative complications were noted in the post operative hospital stay in all the 14 patients, of this 1 patient (7.14%) developed wound infection. Only late post operative complications were noted during the follow-up period on outpatient basis. There were no mortalities noted in the intra-operative or the immediate postperative period.
Conclusion: A good clinical assessment with investigations, treatment of associated complications and a combination of surgical procedures have beneficial effects in minimizing cost and morbidity of varicose vein surgery.