Outpatient management of superficial venous insufficiency at a naval medical facility

Superficial venous insufficiency is common in a young, working population. It can result in disability and lost time from work because of chronic pain, inflammation, and/or ulceration. We reviewed our experience in the management of 104 patients with superficial venous insufficiency secondary to saphenofemoral and/or perforator venous incompetence. The main treatment objective was to control venous insufficiency in a manner that would allow a rapid return to duty. The technique involved ligation of the incompetent saphenofemoral junction and/or perforating veins (i.e., point ligation) under local anesthesia. Patients returned to normal duty status the day after treatment. Six weeks later any persistent disease was controlled with compression sclerotherapy. Significant morbidity included postoperative wound complications in 4% and thrombophlebitis in 14%. Objectives of treatment, with excellent functional and cosmetic results, were achieved. True recurrence was noted in 8% of patients, whereas new disease developed in only 4%; the total recurrence rate was 12%. This mode of therapy is ideally suited to outpatient management. This study demonstrates the excellent control of venous dysfunction that is achievable with the use of selective therapy based on proximal venous ligation and staged sclerotherapy.The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, D.C., Clinical Investigation Program sponsored this study No. S-94-063, as required by HSETCINST 6000.41A.Veluntary informed consent of the subjects used in this research was obtained, as required by SECNAVINST 3900.39B.The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States government.