Varicose vein

                                Varicose Vein (varicoty)

• Varicose vein or varicoty are abnormally dilated, tortuas superficial vein cause by incompetent venous valve.
• varicose vein are permanently distended veins that develop from the loss of valvular competence faulty valves elevated venous pressure causing distention and torluosity of superficial veins.
• varicose vein is divided in two types according to cause :-

1. Primary
2. Secondary

1. Primary varicose vein :-  vein after resting from congenital, genetic, or familial predisposition that                                               leads to loss of elasticity of the veins valve.

2.Secondary varicose vein :- it occurs when trauma , obstruction deep vein thrombosis or                                                                   inflammation cause damage of valves.

Etiology and Risk factor :-

• Prolong standing 
• Genetic predisposing factor
• Weakness of vein valves
• Congenital deformities
• Pregnancy

Clinical manifestation :-

• Dull-ache
• weakness
• moderate swelling
• malaise
• fever
• noctural cramps
• edema
• Pigmentation
• Ulceration
• susceptibility to injection
• Unslightly appearance of legs

Diagnostic evaluation :-

• Duplex scan :- to asses or find out anatomy of veins
• Venous blood pressure
• Venography

Management :-

1. General management :-

• the patient is instructed to avoid activity that cause venous stasis such as wearing light shocks or constructive griddles crossing. the legs at the thigh or sitting or standing at the long period. Instruct the client for changing the position frequently, elevating the legs which feels tired & getting up to walk for several minutes of every hour to promote circulation.
• the patient should be encouraged to walk 1-2 mile per day.
• Elastic wrap need to be wrapped twice daily so that greatest pressure is at the ankle with lessor pressure gradually applied at the level of knee.

     2.  Surgical management :-

• Sclerotherapy :- (using a fine therapy) :-  Sclerotherapy is the injection of a sclerosis agent      into varicose vein. The agent damage the vein and endothelial causing to swell the blood to clot. the vein turn into sear tissue that many eventually fade from view.It is used for spider veins of varicose veins up to 15 millimeter in diameter have been treated successfully.  
• Vein ligation and Stripping :- surgical management of varicose vein consist of ligation of        greator sphenous vein with its tributaries at the sphenofemoral junction. Combind with removal of the sphenous vein (stripping) & ligation of incompetent performance vein.Removal of vein is performed through multiple short incision. An increase made at the ankle over the sophenous vein and a nylon wire is threaded up vein to groin.
• Saphenofemoral ligation :- some client requires only typing of the junction of the saphenous  & femoral vein at the groin. this involves one short incision often local anesthesia & no hospital stay.

Nursing management:-

• Maintain firm elastic pressure over whole limb.
• Promote regular movement &exercise of legs.
• Elevate the foot to bed 6-9 inches so the legs are above the heart level which the client is in bed rest.
• Instruct client to walk rather than stand or sit.
• Asses for any signs of complications such as infection , hemorrhage , nerve damage etc.