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What is recovery like for microphlebectomy?

This question was asked in Bronx, New York and has 8 answer(s) as of 07/05/2013.
How long will I need to recover after microphlebectomy? What kind of local anesthetic is used during? What side effects should I expect?


Doctors Answers (8)

Microphlebectomy = Small 2 mm's stab incisions along the varicosities are required in addition to local tumescent anesthesia is required to remove the varicose veins. The larger the varicosities, the easier it is to tease them out of the legs. You can expect an average of 10-12 stabs depending on how much there's to remove. This procedure is done in an Operating Room, under sterile conditions. The stab wounds usually do not require stitches, only a compressive wrap for 2-3 days, which is subsequently changed by the physician and replaced by a similar compression wrap for another few days. After about 7-10 days, you wear your compression hose. The cosmetic results are usually excellent, at 4 months, you hardly can see the scars. For the first 3 weeks, there can be minor bruising along the tracks of the veins. This is temporary.

A microphlebectomy done in our office uses a tumescent anesthetic that is mostly a dilute buffered lidocaine in sterile normal saline injected around the vein to be removed. The procedure includes several small injections of the anesthetic solution and after that the rest of the procedure should be completely painless. The vein is removed through several 1mm incisions along the length of the vein and so is minimally invasive. There are no changes in regular activities other than wearing compression hose and avoiding baths and hot tubs for several weeks after the procedure. Walking and aerobic activities are beneficial and encouraged. No suture is needed to close the 1mm incisions and steri-strip medical tape is used. Mild soreness and slight bruising may occur. The cosmetic effect is typically seen immediately and by 1 month after the procedure it is usually not possible to see the location of the removed vein or micro-incisions used to remove the vein. A microphlebectomy also has the advantage of avoiding trapped blood often seen in sclerotherapy of larger veins as well as avoiding any staining due to trapped blood.

Recovery time for microphlebectomy is straightforward and of shorter duration than when combined with EVLA. Most patients return to normal activity the next day. We apply dressings for 48 hours and then our patients wear hose for one week. I have them massage gently with Arnica cream which speeds the healing and bruising resolution. Normal exercise can begin within days but gradually returning to a more vigorous form of exercise over one to two weeks. Again this varies from person to person, the size and number of veins removed, etc.

Because it is done using local anesthesia only, you may drive home, minimal pain control is needed. Lidocaine is the most commonly used drug. Possible complications should be discussed with your physician.

Microphlebectomy most often is performed using local tumescent anesthetic similar to that used for endovenous thermal ablation. While an oral drug prior to the procedure to lessen the discomfort of instilling the local aneshetic is desirable, intravenous sedation or general anesthesia are not needed. Most patients have minor pain after the procedure which is managed with nonsteroidal anti-inflammatory drugs such as ibupofen or naproxen, but some need small amounts of oral narcotics for a few days after the procedure. We encourage walking begining a few hours after the procedure and we ask patients to avoid vigorous physical activities for one week after microphlebectomy. There often is a small amount of drainage of thin, bloody fluid from some of the incisions for a few days which is managed with dressing changes and support hose. The area of treatment is tender for a few days to a month or so, mostly depending upon the severity of the skin changes existing prior to surgery due to the varicose veins. Ultimately, the skin becomes smooth and soft with tiny scars, 2-3 mm in length, for most patients.

Microphlebectomy uses dilute local anesthetic. The recovery time is maybe a week or two. There will be some soreness at the site, bruising, drainage from the area for a few days to a week.

The recovery from microphlebectomy is very short. I tell my patients that after micrphlebectomy that they avoid heavy strenuous exercise for 2 to 3 days. Other than that my patients are free to do anything they are comfortable doing. Most patient will go back to work the next day and will use some NSAID like ibuprofen for discomfort. Bruising would be the most common side affect, and occasionally patients my have a small area of numbness in the area of the phlebectomy. I use tumescent anesthesia, which is lidocaine diluted in saline solution. It is very effective and avoids a lot of the burning associated with traditional local anesthesia.

All depends on the extent of the procedure. Usually 1-2 days is sufficient, however you need to ask your Phlebologist who performed the procedure.

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