Introduction | Etiology or Risk factor | Clinical Manifestation | Diagnostic Evaluation | Management |
- The varicose vein or varicosity is an abnormally dilated, tortuous superficial vein caused by an incompetent venous valve.
- varicose veins are permanently distended veins that develop from the loss of valvular competence faulty valves elevated venous pressure causing distention and tortuosity of superficial veins.
- a varicose vein is divided into two types according to cause:-
1. Primary varicose vein:- vein after resting from congenital, genetic, or familial predisposition that leads to loss of elasticity of the veins valve.
2. Secondary varicose vein:- it occurs when trauma, obstruction deep vein thrombosis, or inflammation cause damage of valves.
Etiology and Risk factor of Varicose vein or Varicosity:-
- Prolong standing
- Genetic predisposing factor
- A weakness of vein valves
- Congenital deformities
Clinical manifestation of Varicose vein or Varicosity:-
- moderate swelling
- nocturnal cramps
- susceptibility to injection
- The unsightly appearance of legs
Diagnostic evaluation of Varicose vein or Varicosity:-
- Duplex scan:- to assess or find out anatomy of veins
- Venous blood pressure
Management of Varicose vein or Varicosity:-
- the patient is instructed to avoid activity that causes venous stasis such as wearing light shocks or constructive griddles crossing. the legs at the thigh or sitting or standing in a long period. Instruct the client for changing the position frequently, elevating the legs which feel tired & getting up to walk for several minutes of every hour to promote circulation.
- the patient should be encouraged to walk 1-2 miles per day.
- The elastic wrap needs to be wrapped twice daily so that the greatest pressure is at the ankle with lessor pressure gradually applied at the level of the knee.
2. Surgical management:-
- Sclerotherapy:- (using a fine therapy):- Sclerotherapy is the injection of a sclerosis agent into a varicose vein. The agent damage the vein and endothelial causing to swell the blood to clot. the vein turns into sear tissue that many eventually fade from view. It is used for spider veins of varicose veins up to 15 millimeters in diameter and has been treated successfully.
- Vein ligation and Stripping:-surgical management of varicose vein consists of ligation of a greater saphenous vein with its tributaries at the saphenofemoral junction. Combined with the removal of the saphenous vein (stripping) & ligation of incompetent performance vein. Removal of a vein is performed through multiple short incisions. An increase made at the ankle over the saphenous vein and a nylon wire is threaded up vein to the groin.
- Saphenofemoral ligation:- some client requires only typing of the junction of the saphenous & femoral vein at the groin. this involves one short incision often local anesthesia & no hospital stay.
Nursing management of Varicose vein or Varicosity:-
- Maintain firm elastic pressure over the whole limb.
- Promote regular movement &exercise of legs.
- Elevate the foot to bed 6-9 inches so the legs are above the heart level which the client is in bed rest.
- Instruct the client to walk rather than stand or sit.
- Assess for any signs of complications such as infection, hemorrhage, nerve damage, etc.