Long cotton wool rolls as compression enhancers in macrosclerotherapy for varicose veins

BACKGROUND. Macrosclerotherapy in combination with compression has proven t o be safe and effective in the treatment of varicose veins. Local compressi on is increased by pads, according to Laplace law. Firm rolls of cotton woo l are fixed over the course of the entire vein to increase local compressio n and to reduce complications. Additional compression is given by a combina tion of a class I (daytime and nighttime) and class II (daytime only) medic al compression hosiery. PURPOSE. TO evaluate the effectiveness and side effects of sclerocompressio n therapy with cotton wool rolls in combination with medical compression ho siery. METHOD. Prospective study with 100 patients (120 legs) with primary varicos e veins, which are treated with polidocanol as sclerosant with the empty ve in technique. Immediately after the injection, a long cotton wool roll is p laced over the entire vein and fixed. Additional compression is obtained wi th class I and class II medical compression hosiery. The interface pressure on the skin, just under the cotton wool roll, is measured on 12 legs with the aid of an interface pressure measuring instrument (Oxford Pressure Moni tor). RESULTS. Good sclerosing results are obtained in all patients. Side effects are classified as early and late. In 16 patients, minor side effects which needed no treatment are observed. In only 3 cases (2.5%), intravascular bl ood clots (2) and phlebitis (1) needed incision and expression. The mean in terface pressure of all measuring sensors under the cotton wool roll is 84 mm/Hg (68 to 122 mm/Hg). CONCLUSION. This study proves the high effectiveness of a cotton wool roll compression right at the place of treatment. By using these long cotton woo l compression rolls, the compression part of sclerocompression therapy beco mes more effective and much easier to perform.