Optimising outcomes in the treatment of lower limb varicose veins
Thesis or dissertation
- © 2012 Anthony Mekako. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Varicose veins are dilated and tortuous subcutaneous veins, which affect a significant proportion of adults. They cause physical and emotional symptoms, and affect quality of life in sufferers. The management of varicose veins has evolved since the early 20th century, when Babcock described what has now become the gold standard surgical treatment. Perhaps the most significant evolution is the development and popularisation of minimally invasive therapy, especially endovenous laser ablation (EVLA) in the last two decades. This thesis focuses on the optimisation of outcomes in the management of this very common condition.
Four studies were performed to evaluate varicose vein treatment modalities and outcomes, investigating key issues such as: the proportion of patients suitable for EVLA; optimisation of EVLA; how does EVLA compare with surgery, and what is the effect of prophylactic antibiotics on wound complications following surgery? Approximately 60% of varicosities are suitable for EVLA, with vein anatomy being the commonest cause for unsuitability. The concomitant performance of phlebectomies at the time of EVLA was shown to be feasible, acceptable to patients, and improved outcomes. EVLA was shown to be clinically effective, and eliminated the early quality of life limitations of surgery. Wound complications following surgery were found to be significantly reduced by the use of prophylactic antibiotics.
- Hull York Medical School, The University of Hull
- Chetter, Ian
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