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

Brasil

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

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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Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) Rua Estela, 515, bloco E, conj. 21, Vila Mariana, CEP04011-002 - São Paulo, SP, Tel.: (11) 5084.3482 / 5084.2853 - Porto Alegre - RS - Brazil
E-mail: secretaria@sbacv.org.br

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[1] SD: standard deviation; IQR: interquartile range; BMI: body mass index.

[TFN1] ^*
Chi-square test.

[TFN2] ^†
t test.

[TFN3] ^‡
Mann-Whitney test.