Varicose is a disease that causes bloating of veins under the skin. To prevent varicose veins, it is necessary to lead an active lifestyle, as this disease appears as a result of stagnation of blood in the limbs.
First of all, at risk are representatives of professions, where you have to constantly stand on your feet, or work all day in a sitting position. Other causes of varicose veins include obesity, hypertension and heredity.
If it is not possible to prevent the development of the disease, then in the treatment of veins in the late stages of development of varicose veins, surgical intervention is required in most cases. The operation of Troyanov-Trendelenburg is one of such methods.
- History of
- development Indications and contraindications for operation of TT
- Before hour "X"
- Description and technique of intervention
- Rehabilitation period and possible complications
- Can it be better to avoid problems?
History of the formation of the
procedure The operation of Troyanov-Trendelenburg( TT) has been used to treat varicose since the end of the XIX century. For the first time such an operation was made in 1887.The author of this technique is the Russian surgeon Troyanov, who worked as head of the department of the male Obukhov hospital in St. Petersburg.
A little later( in 1890), his German colleague Trendelenburg began to apply it. This same year dates the first mention of the method in the medical literature.
Consequently, in honor of these two surgeons, surgical intervention on the veins( now called cross -ectomy) was called. A great contribution to the development of this method of treatment of veins was later introduced by Dieterich, but the name of the operation remained unchanged. The essence of the intervention is to create a cut through which a large subcutaneous vein is removed.
A surgeon should be examined to ensure that after treatment of veins with this method, the patient will not experience complications. The main disadvantage of the method is a large scar that remains on the thigh after the operation.
Indications and contra-indications for operation of TT
Trostenberg's CrossTectomy Trendelenburg is performed in such cases:
- acute thrombophlebitis of the large saphenous vein( BPV);
- development of thromboembolism;
- lymphatic stasis;
- lymphovenous insufficiency;
- valve failure of BPV.
Among the contraindications to the conduct of a crossectomy include viral and bacterial infections that cause an increase in body temperature, cause a fever of the whole body, lead to kidney and hemopoiesis, increase blood sugar levels.
In addition, it is forbidden to perform an operation in the presence of infectious lesions of the skin in the surgical access zone.
Before the "X" hour
The required minimum of the survey for the intervention includes:
- testing for HIV infection, as well as viral hepatitis B and C;
- holding a coagulogram;
- blood test;
- examination with a physician-therapist.
- duplex scanning of veins with the help of ultrasound, which helps to determine the location of the thrombus.
Before the operation, you need to shave your legs and buy special compression underwear. The choice of the latter must be approached with all seriousness, because it must be of the right size and of good quality.
If the opportunity to buy such clothes is not available, then before cross -ectomy legs are rewound with elastic bandages.
Description and intervention technique
Before conducting a cross -ectomy, the patient decides which type of anesthesia to choose: general or local. Many circumstances can affect his decision, however, in most cases it is the patient who has the last word. Below are the main stages of the Trendelenburg operation:
- the surgeon processes the operating field;
- makes a cut on the skin near the groin;
- identifies an anastomosis with BPV;
- binds the HPV.
When conducting CT cross -ectomy three operative accesses are used: inguinal, oblique, and ephedra. When the operation is performed on the femoral vein, a vertical incision is made in a very methodical and accurate manner along the projection of the vascular bundle.
After the tissue has been cut, the surgeon selects a large subcutaneous vein. To determine the location of the anastomium, it secrete part of the subcutaneous and femoral vein at the junction site.
After treatment of the proximal tributaries, the doctor crosses the subcutaneous vein with clamps. Vein ligation is performed at the place where it falls into the femoral vein.
Next, the joints must be seamed in place of the cut. The disadvantage of this method of treating thrombosis is a large scar that forms on the body after the operation. After this, a loinclout should be applied on the wound, which the doctor will periodically take off during further examinations.
It is important to apply the dressing as tightly as possible, especially when it comes to the initial stages of rehabilitation. The patient should start walking immediately after leaving the room to activate the work of natural processes in the body.
It is advisable to resort to the operation of Troyanov-Trendelenburg only when the surface thrombophlebitis has not yet developed. If the latter is found, surgery is urgently required, which should be carried out no later than two days after the diagnosis of the disease.
Trotanova's hysterectomy - the technique and the course of the intervention:
Rehabilitation period and possible complications of
The patient will have to undergo a one-week rehabilitation course in the hospital. If the patient's condition is all right, the doctor will remove the stitches.
Compression linen or elastic bandages will need to be worn for a month. This is followed by a period of conservative therapy, which includes the adoption of funds that improve blood circulation, as well as anti-inflammatory drugs. All this will contribute to the rapid correction of the patient after surgery.
Due attention should be paid to physical activity. As already mentioned above, early activation of natural processes in the body will prevent further formation of thrombi, as well as restore normal blood circulation in the body.
It is more useful to walk outdoors, spend less time sitting or standing, becausethis will increase venous congestion.
Complications after surgery are rare, but they can still be. Among them there are:
- In the first days of possible weak bleeding from wounds .
- Suppuration of wound .This complication is rare, and only when antiseptic norms are not observed.
- Problems with the circulation of lymph vessels. .Possible with damage to blood vessels.
- Change in skin sensitivity .Is the result of violations of the central nervous system. Unpleasant abnormal sensations are also possible.
- Thrombosis and embolism .Such a complication is rare.
As a rule, the surgeon's professionalism does not lead to disruption of the nervous system or large veins.
Post-operative rehabilitation usually proceeds fairly quickly, and it is not accompanied by any painful sensations.
The patient is not limited in movement, as, on the contrary, it is encouraged by doctors. The main thing is to stick to the regime and wear a special compression bandage that will support and facilitate the rapid restoration of the damaged area.
After one month's passage, compression lingerie can be taken only at night, and in the daytime it is recommended to continue wearing it for at least a month. Finally, you can refuse compression knitwear or bandages only after permission of the doctor.
Can it be better to avoid problems?
To prevent varicose veins, it is recommended to spend a lot of time swimming in the pool, as this helps to normalize blood circulation in the lower extremities. You can do with small physical exercises in the morning.
It is also important to wear only comfortable shoes, especially if some signs of varicose have already begun to appear. It is strictly forbidden to wear shoes with high heels.