Varicose veins

varicosityVaricose veins is a disease manifested by significant expansion of the lumen of the veins, the increase of their length, the change of form with the formation of brains and units. Often affects the veins of the lower extremities, in the first place subcutaneous veins of the lower leg ( Fig. 1), and rectum (see Hemorrhoids), and Vienna spermatic cord (see Varicocele). Predisposing moment in the development of varicose veins is a congenital weakness of the venous wall, a direct cause - conditions that hinder the outflow of blood from the lower extremities into the veins of the pelvis, for example: prolonged standing, related to the specific features of the profession (hairdressers, cooks and others); labored pelvic veins gravid uterus or tumor; the obstruction of the deep vein of the thigh after suffering thrombophlebitis (see). Women get sick more often.
As overflow and stretching veins clearance them increases, there is an insufficiency of venous valves, which increases the stagnation of blood and accelerates further stretching of Vienna in width and length. The disruption of blood flow in varicose veins often leads to thrombosis (see). In blood clots may otlojitsa lime, then formed the so-called public stones - globalitythat are well be felt under the skin.
Permanent stagnation of blood leads to swelling of the limbs and malnutrition tissue. Skin becomes thin and prone to mechanical damage. Large site of the revised Vienna can be opened through the thinning the skin, there is abundant bleeding. Malnutrition tissue over time leads to the formation of hard healing varicose ulcer (see Ulcer). These ulcers are the entrance gates of the infection, and the disease so often complicated by thrombophlebitis. For long-existing varicose veins and re thrombophlebitis on the skin of the legs usually appears brown or dark brown pigmentation (Fig. 2).
Varicose veins of the lower leg causes a feeling of heaviness, Lomaia leg pain, which, unlike pain with obliteriruuschem endarteriite (see), do not arise when walking, and when long standing. The pain intensifies the evening, and during the night pass. Advanced varicose veins accompanied by a large swelling in a limb and ulcers, makes walking difficult and even impossible.
Treatment of varicose veins. Conservative methods are used in the initial stages of the disease, and in severe forms - in preparation for surgery or if the operation reason is contraindicated (for example, in old age of the patient). In the initial stages of varicose veins of the lower leg useful bondage elastic bandage compressive saphenous vein. The bandage is put in the morning, in bed, on a slightly elevated leg, putting a stop at a right angle. Bondage start from the base of the fingers and the lead up to the knee, leaving the heel open (otherwise bandage will get when walking). Bandage need evenly and tightly pulling the bandage, except the first and the last turnover (tour). Depression on the sides of the Achilles tendon and under the ankles filled with cotton wool. On top of the bandage is put regular stocking. Easier and more comfortable wearing elastic (rubber) stocking, but he's got to fit exactly in size limbs and sold-to-measure taken by a doctor-orthopedist. Wearing elastic bandage or stocking unacceptable, if simultaneously with varicose veins there and the defeat of arteries limbs. Therefore, before you can assign them, you must verify that pulsates whether artery on the rear foot.
In addition to wearing elastic bandage (grip), the patient should be several times a day for 10-15 minutes to lie down with a raised cushion foot or even to sit, putting the affected leg on a chair.
Conservative treatment in preparation for operations conducted in the presence of varicose ulcers in order to achieve its healing, as if the plague be not operate (the risk of infection!). Often it is enough to lay sick in bed for 1-2 weeks from elevated on pillows foot; for the plague, and put a bandage with Vishnevsky ointment or syntomycin emulsion. If that were not enough, for healing ulcers with success can be applied zinc-gelatin band of bandages saturated paste of the following composition: Zinci oxydati, Gelatini AA 20,0, Aquae fontanae, Glycerini aa 80,0. Pasta with cold kind of tough jelly, heated on a water bath to the consistency of liquid sour cream. A raised leg bontout on the skin (without wool) gauze bandage, densely lubricating each round it a paste using a large brush (to check for your own skin, not too hot pasta!). Bandage impose knee 10 - 12 layer of bandage and carefully modelled. After freezing it provides a uniform elastic pressure, ulcers and under it often heal well. Zinc-gelatin bandage it is expedient to apply and those patients who radical treatment is contraindicated in General. To change the bandage need 1 time per month.

Indication for surgical treatment of varicose veins is developed insufficiency of venous valves. Their condition determine the breakdown of the Troyan - Trendelenburg. In full, with the imposition of a rubber strap, this sample is carried out by a doctor. In simplified form, it can be executed average health worker as follows. Placing the patient on his back, raised his foot and stroking from foot to hip void dilated veins. Then at the base of the thigh pressed saphenous vein fingers, ask the patient to get up, then stop pressing. If Vienna immediately filled with blood from the top down, there is a lack of valves (Fig.). Slow filling veins of the bottom-up indicates no failure of the valves.
Surgical treatment of varicose veins can be bloodless and bloody. Bloodless, injection, or sclerosing, the method is not effective enough; it consists in injection extended in Vienna substances that cause the obliteration (neglect) of the vessel. More often for this purpose used variation. For injection apply a thin needle and syringe with a capacity of 2 ml Injections, puncture 2-3 node in 3-6 days. After the drug impose elastic bandage. Bloody methods consists in removing varicose veins. The most radical way of Madelung - excision of the entire system of varices (from the Foundation of the thigh to ankle), but it is very traumatic. Most often used method of Babcock (combined), which initially producing bandaging popliteal vein in the thigh at a place where it flows into the deep femoral vein (Trendelenburg - Troyan), and then produce the following: through a small incision on the thigh vein cross and distal end impose long tube made of thick soft wire extension in the form of Oliva on the end. Then it is done on the lower leg, trying to reach the ankles. Through a small incision on the lower end of the instrument Vienna naked, crossed and tied to the end of the probe; traction for probe remove the whole of Vienna. The remaining node to remove from the separate sections. In the postoperative period, the patient permitted gradually to rise (from the 4th day after surgery) must imposed elastic bandage, the wearing of which is obligatory for 6 months.
As sclerosing and bloody operation designed to fully focus outflow of blood through the deep veins that are not subject varicose expansion. If the deep veins are not operational (for example after a deep thrombophlebitis), the operation is contraindicated.
Varicose veins in pregnant women. Pregnant women may develop quickly a large varicose veins of lower limbs, sometimes together with hemorrhoids or swollen veins external genital organs. At small degrees of expansion it may disappear after delivery, but will resume when repeated pregnancies, every once in a more severe. Prevention - the fight against constipation, walking, swimming, exercise. Avoid prolonged standing. Wearing all of the garter is contraindicated. In patients with severe varicose veins shown translation pregnant easier work, early direction in maternity hospital.