Post-op Ambulatory Phlebectomy or Ligation Instructions

What to Expect After Ambulatory Phlebectomy Procedure:

The numbing medication infused may last 4-6 hours. You may have mild discomfort as this wears off.  Dr Harper recommends that you take Tylenol to control your post-procedure discomfort.  Please note dosage and frequency recommended on back page.  If you have history of adverse reaction to Tylenol, do not take.  Please notify clinical staff of your reaction history.

If the Tylenol does not relieve your symptoms it is important to call a nurse.  You may be instructed to take an anti-inflammatory medication (Motrin or Advil) for your symptoms if it is at least 36 hours post-procedure.  **If you have another procedure pending, remember to stop all anti-inflammatory medications 5-7 days in advance.  ** You may also apply ice to affected sore areas (10 minutes twice daily with cloth barrier over skin).  Start ice packs the day after procedure. (NO heating pads).

You may have mild swelling for several days due to the local anesthetic infused into your leg.  It is normal to experience bruising for 1-4 weeks; everyone bruises differently.  Some patients notice knots in their leg after the procedure.  These knots are actually bruises or dried blood. Do not be alarmed; this will gradually improve. Y ou may wish to purchase Arnica Montana, a homeopathic medication, from our office to help with your bruising.  (Dissolve 5 pellets under your tongue three times a day for 5 -10 days post-procedure).

Activity Recommendations and Restrictions:

To speed your recovery and healing, it is important that you walk frequently and wear your compression hose.  Please do not sit or stand in one place during waking hours for more than 2 hours without walking.  It is important that you interject walk breaks periodically through the day to keep swelling and discomfort controlled.  These breaks can be a couple of minutes of walking.  In addition to your periodic walking, it is important to walk for exercise starting the day after your procedure.  Please walk 30-60 minutes a day as tolerated.  You may split this exercise into increments if needed.

Please return to normal activities as soon as possible but avoid: prolonged standing and sitting, heavy weight lifting, running, jogging or swimming for one week.  As stated below you will need to wear your compression hose until your follow up appointment (2 weeks).

Types of Dressings on your Legs:

You may have 4-5 layers of dressings on your leg after your procedure.  These layers include (beginning with the inside layer): 1) suture strips (Band-Aid) over any incision, 2) gauze wrap, 3) pads to collect any drainage, 4) fishnet to keep the pads in place, 5) Compression hose.

Important Leg Dressing Instructions:

• Day of the Procedure: Keep dressing intact
• Night of the Procedure: Sleep with dressings and compression hose in place
• Day after the Procedure: If you are not coming to the office for your dressing change remove the hose, fishnet, gauze and pads FIRST THING in the MORNING.  Throw soiled pads away.  Replace any loose, wet, or missing bandaid (suture) strips.  Leave all dry bandaid strips in place, even if soiled.  Pealing the strips off and on too soon or often will slow down your healing process.  You will leave suture strips in place for 5-7 days allowing the incisions time to heal.  After assessing your suture strips, adorn hose and continue wearing hose all day.   If the strip is covering a suture (stitch), please leave covered until your return visit.  If you experience drainage do not be alarmed.  The fluid we pumped into your leg may leak anywhere from 24 -48 hours after the procedure.  The drainage may be pink, bloody, or yellow. Simply keep the draining areas covered with gauze or tissue so your clothes and furniture do not get soiled.
• Night after the Procedure: You may shower tonight.  Avoid tub baths and standing water for 1 week.  Wash over bandaid strips lightly with soap and water.  We recommend Techni-care soap for showering.  Techni-care soap may be purchased in our office.  Lather soap on affected leg. Rinse off after 1 minute.  The suture strips will not wash off.  After you are dry from your shower adorn hose and sleep in hose again.  You will sleep in hose for 2 nights total (last night and tonight).

Continue wearing hose daily for 2 weeks or until otherwise noted on your return office visit. Dr Harper may recommend some patients wear long-term compression hose.

Additional Post Operative Instructions

• Walk, Walk, Walk
• The suture strips leave tape residue on your skin.  To remove the residue, apply baby oil or baby oil gel to these areas and let them soak for a long period.  Then shower and gently rub the residue off.  The residue will eventually wear off.
• If you are hurting proceed through these steps: 1) WALK, 2) elevate, 3) take Tylenol, 4) call a nurse
• If you have drainage remember, do not be alarmed.  It is normal for the fluid we infused to leak out.  Simply keep the draining incisions covered with tissue, gauze, or washrag so that your clothes and furniture do not become soiled.  If the pads will not stay in place (near groin, above thigh high hose), consider using an inexpensive nylon panty hose, spandex shorts or boxer briefs to keep pads in position.

Medication recommended:

• Tylenol ES 1-2 tabs (500mg- 1000mg) every 4-6 hours as needed.
• If additional prescriptions are needed Dr Harper will notify you of these prescriptions.

Driving Restrictions:

• Do not drive until next morning if you took relaxation medication.

Next appointment:

• 1-2 weeks follow up (or 7-10 days if suture removal)

Contact information:

Please call Dr Harper's nurses (Elizabeth Hall, Brenda Hutcheson, Priscilla Johnson) at the office with any questions (478-743-2472).  A staff member will call you the next working day after your procedure for follow up.

For any questions or concerns after hours, please call Dr Harper on his cell phone
(478-743-2472).**