VEC Home Instructions Following Keyhole Varicose Veins Surgery

What to expect following the procedure?

1. You may experience some pain and discomfort such as aching, cramping and tightness in the thigh and calf when the local anaesthetic and pain killers from surgery starts to wear off. If the worse level of pain intensity you ever had is a score of 10/10, this procedure is usually 1-3/10 in severity. This is easily remedied with simple oral analgesia, which will be provided on the day ward. 

2. You will experience some degree of bruising and phlebitis (inflammation of the faulty vein we have blocked off) in the inner thigh and calf over the next few days. Please do not worry as this is normal post and will resolve over the following 1-2 weeks.

3. You may experience some degree of swelling and induration around the thigh, lower calf and ankle post-operatively, which is normal and should resolve over the coming week. Please take the anti-inflammatories and Daflon tablets prescribed, which will mitigate the symptoms along with reducing the risk of developing phlebitis.

4. You may develop a pulling sensation or feel a hard cord along the inside of your thigh or calf, which is where the faulty great saphenous vein (GSV) has been ablated or on the back of your calf where the small saphenous vein (SSV) is situated. Please don’t worry – this can be normal especially if the vein is situated close to the skin surface. This discomfort and feeling will likely resolve over the next 2-6 weeks. You will most likely experience this feeling when you first wake up in the morning and during periods of inactivity especially sitting and standing for a long time. Walking and elevating your feet during inactivity will help alleviate these symptoms.

5. It is also normal to see and feel some residual lumps under the skin surface post- surgery especially if you had some concomitant phlebectomies or sclerotherapy to the side branch veins. This will usually resolve over the next 2-4 weeks.

What you CAN and CAN’T do after surgery?

6. You are encouraged to walk immediately after the surgery to get the circulation moving and reducing risk of deep vein thrombosis (DVT).

7. You can go for 15-20 minutes walks on Day 1 following the procedure.

8. Refrain from resistance training or high impact sports or aerobics for 10 days and from swimming until the stitches have been removed (usually day 8-10 post-op) 

9. Try and do some regular exercises to work the calf muscle to help pump the venous circulation in your leg, such as going up and down on your tiptoes, bending your knees (marches) and squats (if you can)

10. No leg massage for 6 weeks – this may cause unnecessary irritation to the leg. 

11. No raw seafood for 2 weeks especially if you have had phlebectomies (theoretical increased risk of infection) 

12. Do not sunbathe for 2 weeks – may cause unnecessary skin pigmentation. 

13. Driving – refrain from driving for 48 hours – especially if your right leg was operated on and until you can safely break without pain. Please arrange for someone to drive you in and take you back on the day of the surgery or arrange a GRAB driver. Sedation given to you peri-operatively may not have fully worn off and cause drowsiness and reduced reflex reactions.

14. You are advised not to fly ideally within the first 10-14 days after surgery, especially longhaul (> 5 hours). This may increase your risk of DVT/lung clot and early re-opening of the closed vein. Please inform your vascular specialist if you need to fly within 2 weeks. He may cover you with some blood thinners for the flight journey. You should wear compression stockings when you fly and walk around the plane regularly.

What about the bandages and use of compression stockings?

15. The compression bandages placed on your legs post-operatively are there to help with the recovery process and give your legs support especially immediately after the surgery. Please refrain from getting them wet and try and leave them on for 36-48 hours after the procedure until you are reviewed back in clinic. If you want to shower the rest of your body before review, you can cover the compression bandages with a large trash bag and secure to the skin with clear sticky tape. If the dressing were to get wet, you can use a hairdryer to blow dry the wet areas. On the morning of the appointment, you can remove them before coming to clinic. 

16. Please come on the day of surgery with loos fitting trouser/shorts and som sandals to allow you to walk out easily with the compression dressings. 

17. If you need to remove them before you are reviewed, please leave the waterproof dressings underneath on the wounds. You can shower with these dressings on. 

18. You will be given some spare waterproof dressings to use if there are wounds that are still oozy and dressings need replacing.

19. lease keep all wounds with stitches/ steristrips until they are inspected by your doctor.

20. After your post-operative review at 48 hours, you should try and wear your compression stockings for 2 weeks to help alleviate any discomfort and swelling. You don’t need to wear it all day and may remove the stocking when you sleep at night. You may also opt to leave the stocking on at night if you find it difficult to put it on too. Try and keep the stocking on for 6-8 hours every day especially if you are active and work in a profession that involves long periods of standing and sitting down (teacher, cashier, F&B industry, nurse, desk-job). This will give you leg support during the first 2 weeks.

Returning to work?

21. ou may return to work on the day of surgery if you like but we would suggest at least 1 day of rest before you do so. Ideally those who have stitches should have these removed before they go back (at 8-10 days). We are happy to issue hospitalization leave for up to 3 weeks if you so wish.

Medications post-operatively

22. esume all your usual medications immediately until advised otherwise by your doctor.

23. VEC will issue a cocktail of medications to optimize your post-operative recovery. These include: anti-inflammatories (for pain and reduce the inflammation/phlebitis risk), Daflon tabs (help vein healing and reduce risk of cramps and swelling), antibiotics (to reduce risk of infection) and Hirudoid/Cicastim cream (anti-inflammation and bruising cream).

Please contact us if you experience any of the following: Fever, chest pain, shortness of breath, severe leg swelling and pain and areas of redness, worsening swelling and pain.

By Whatsapp (24 hours): +65 9173 0272

Thank you for your attention,
Dr TANG Tjun Yip
Dr Julian Wong