Profuse bleeding in patients with chronic venous insufficiency.
OBJECTIVE
The aim of this retrospective study was to compare the healing rates of patients where the bleeding points were sutured (n=52) against those where the bleeding was controlled using compression sclerotherapy (n=72). The incidence of re-bleeding was also followed over a 12-month period.


METHODS
During 1999-2003, we treated 124 patients (86 women and 38 men; mean age: 64 years, age range: 36-85 years) with profuse bleeding from varicose veins as emergency cases. Seventy-two patients (58%) were treated with compression sclerotherapy. In the suture group of 52 patients (42%) the bleeding points were treated in the emergency outpatients department. Usually a cross stitch was used and the same type of uninterrupted compression as in the sclerotherapy group was applied for 6 weeks afterwards.


RESULTS
In the group of patients where compression sclerotherapy (Fegan's method) was used to control the bleeding (65 patients), the average time taken for the wound to heal completely was 7 days (5-13 days). There was no recurrence of bleeding in the subsequent 12 months. In the group of patients where a suture was used to control the bleeding, the average time of healing was 14 days (11-19 days) and re-bleeding occurred in 12 cases (23%).


CONCLUSIONS
Using Fegan's technique of compression sclerotherapy with a low concentration of sclerosant (0.2% sodium tetradecyl sulfate), it is possible to treat bleeding varicose veins effectively with significantly faster healing of the wound.
Labas
P
P
1st Department of Surgery, University Hospital Bratislava, Bratislava, Slovakia. peterlabas@hotmail.com
Cambal
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D015994:Incidence; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012008:Recurrence; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D012720:Severity of Illness Index; D012981:Sodium Tetradecyl Sulfate / Q000627:therapeutic use; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014689:Venous Insufficiency / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D014945:Wound Healing
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate