Your questions answered by vein experts

Q1 My husband has just had laser surgery for a venous leg ulcer. He has been told that the district nurses will need to come in twice a week, as he will need compression bandages. We can't understand why he ALSO needs compression bandages. The specialist says he will need this and stockings for the rest of his life. Could you please comment, as we need a second opinion and a way of going forward with his healing process, without the need for compression bandages.

A.

This does indeed sound strange – usually if the correct vein is lasered using the right technique, then the ulcer should heal.
 
A recent study from The Whiteley Clinic has shown that provided the patient can walk, just over 50% should completely heal, about 34% still need a stocking – and only 16% need compression bandages.
 
It might be that your husband is not walking well? Or has a large amount of swelling? Or has he had bad DVTs (Deep Vein Thrombosis – www.deep-veinthrombosis.com)  in the past?
 
If none of these, it might be that the laser hasn’t been successful or it may be that the surgeon did not treat perforating veins (www.perforatorveins.com) at the same time, which often cause ulcers (www.leg-ulcers.com).
 
If your husband is walking, doesn’t have a very swollen leg and hasn’t had bad DVT’s in the past, then he probably needs a Duplex ultrasound (www.duplex-ultrasound.com) scan by a specialist vein unit (http://www.collegeofphlebology.com/specialist-search/) to find out what is going on and what is possible. 
 

Q2 My son has just had EVLA done on his leg - the larger/deeper vein - and he is bruised from his groin the whole way down his leg. It looks like someone took a baseball bat to his leg. I am due to have mine done in a month, but am hesitant. What definitely are the pros to having this procedure done?

A.

Thank you for your question.
 
As with all medical procedures, the success of the technique depends on:
 
1) the equipment used
2) the technique used by the doctor
 
There are many different sorts of EVLA - some less painful than others, depending on several factors such as wavelength and fibre used.
 
However, the technique needs to be modified for each patient to make sure that the vein is adequately closed with minimal risks of skin damage.
 
It is very rare to have a result like you describe with your son. It might just be unfortunate - or it might be that the team doing the procedure isn't very experienced in the technique.
 
EVLA, when done optimally, has many advantages over vein stripping - but you do need to check that you are having it done under local anaesthetic by experts who do many every week and get a high level of patient satisfaction.

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