MORBIDITY OF VARICOSE-VEIN SURGERY - AUDITING THE BENEFIT OF CHANGINGCLINICAL-PRACTICE

During two consecutive study periods (24 months and 16 months), 997 pa tients (1322 legs) with varicose veins underwent surgical treatment in Huddersfield Royal Infirmary, using a variety of surgical techniques. The average length of stay was 1.5 days, and 95.5% of patients had a hospital stay of less than 2 days. Complications occurred in seven inp atients. A further 16 patients developed complications requiring readm ission to hospital (10 minor and intermediate; 6 major). The complicat ion rate appeared to be operator-dependent: an increased complication rate (particularly major complications) occurred after surgery by juni or surgeons. Major complications included femoral vein injury (I patie nt), postoperative deep venous thrombosis (4 patients), pulmonary embo lism (1 patient) and groin lymphatic fistula requiring reoperation (1 patient). Between the first and second study period, a change in polic y regarding the type of bandaging used and the use of postoperative an tiembolic stockings occurred and appears to have reduced the incidence of thromboembolic complications from 0.7% to 0.2%. Varicose vein surg ery is not without major complications though, fortunately, there was no mortality in this series. These complications can be minimised with good surgical technique and better supervision of surgical trainees. Modification of postoperative management can further enhance the safet y of this procedure.