Intermittent pneumatic compression following varicose vein surgery.

Abstract Objectives Intermittent pneumatic compression (IPC) is an established treatment option to remove tissue fluid in patients with lymphedema and chronic venous disease. The effects of IPC directly applied after varicose vein surgery performed with high volumes of tumescent local anesthesia (TLA) have not been investigated. Aim of this study was to evaluate postoperative IPC, concerning its impact on leg volume and patient comfort after surgery. Design Investigator initiated single-center open-label randomized controlled trial. Materials and Methods One hundred and eighty-six patients indicated for saphenofemoral junction ligation and great saphenous vein (GSV) or anterior accessory saphenous vein stripping or GSV redo surgery were randomly assigned to intervention or control group (1:1). Patients of the intervention group were treated with IPC (40 mmHg, 45 minutes) directly after surgery. Outcome measures were leg volume changes calculated by an optical 3D scanning system (primary objective), quality of life (Freiburg Life Quality Assessment for chronic venous disease, short form: FLQA-VS-10), pain and extent of ecchymosis with follow-up examinations on day 1 and 7 after surgery. Results Patients of both groups had comparable mean leg volume reductions from baseline to day 1 (58.8 ml (IPC group) and 37.4 ml (control group), p= 0,967), and to day 7 (63.1 ml and 57.0 ml respectively, p=0.546). We also did not observe significant differences between groups concerning QoL and pain. Patients of the IPC group developed larger areas of ecchymosis (16% vs. 13,3% of leg surface, p=0.046) tending to an increase of pain one week after surgery as compared with no application of IPC. Conclusions This randomized controlled trial was designed to evaluate decongestive effects of a single postoperative IPC and its impact on QoL, pain, and ecchymosis in patients undergoing varicose vein surgery under TLA. As no evidence for a benefit of IPC could be found in this study, but there was increased ecchymosis, its standard use after varicose vein surgery cannot be recommended.