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Lurie F, Lal BK, Antignani PL, Blebea J, Bush R, Caprini J, Davies A, Forrestal M, Jacobowitz G, Kalodiki E, Killewich L, Lohr J, Ma H, Mosti G, Partsch H, Rooke T, Wakefield T, et al.
Journal of vascular surgery. Venous and lymphatic disorders. Date of publication 2019 Jan 1;volume 7(1):17-28.
1. J Vasc Surg Venous Lymphat Disord. 2019 Jan;7(1):17-28. doi: 10.1016/j.jvsv.2018.10.002. Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. Lurie F(1), Lal BK(2), Antignani PL(3), Blebea J(4), Bush R(5), Caprini J(6), Davies A(7), Forrestal M(8), Jacobowitz G(9), Kalodiki E(10), Killewich L(11), Lohr J(12), Ma H(13), Mosti G(14), Partsch H(15), Rooke T(16), Wakefield T(17). Author information: (1)Jobst Vascular Institute of Promedica, Toledo, Ohio; University of Michigan, Ann Arbor, Mich. Electronic address: fedor.lurie@promedica.org. (2)University of Maryland School of Medicine and Baltimore VA Medical Center, Baltimore, Md. (3)Vascular Centre, Nuova Villa Claudia, Rome, Italy. (4)Central Michigan University, College of Medicine, Saginaw, Mich. (5)University of Houston College of Medicine, Houston, Tex. (6)Northshore University Healthcare System, Chicago, Ill. (7)Imperial College School of Medicine, London, United Kingdom. (8)NCH Medical Group, Arlington Heights, Ill. (9)New York University, School of Medicine, New York, NY. (10)Imperial College London, London, United Kingdom. (11)University of Texas Medical Branch, Galveston, Tex. (12)Lohr Surgical Specialists, Cincinnati, Ohio. (13)The Vascular Experts, New London, Conn. (14)Clinica MD Barantini, Lucca, Italy. (15)Medical University of Vienna, Vienna, Austria. (16)Mayo Clinic, Rochester, Minn. (17)University of Michigan, Ann Arbor, Mich. Guideline 1.1: Compression after thermal ablation or stripping of the saphenous veins. When possible, we suggest compression (elastic stockings or wraps) should be used after surgical or thermal procedures to eliminate varicose veins. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 1.2: Dose of compression after thermal ablation or stripping of the varicose veins. If compression dressings are to be used postprocedurally in patients undergoing ablation or surgical procedures on the saphenous veins, those providing pressures >20 mm Hg together with eccentric pads placed directly over the vein ablated or operated on provide the greatest reduction in postoperative pain.[GRADE - 2; LEVEL OF EVIDENCE - B] Guideline 2.1: Duration of compression therapy after thermal ablation or stripping of the saphenous veins. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after treatment. [BEST PRACTICE] Guideline 3.1: Compression therapy after sclerotherapy. We suggest compression therapy immediately after treatment of superficial veins with sclerotherapy to improve outcomes of sclerotherapy. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 3.2: Duration of compression therapy after sclerotherapy. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after sclerotherapy. [BEST PRACTICE] Guideline 4.1: Compression after superficial vein treatment in patients with a venous leg ulcer. In a patient with a venous leg ulcer, we recommend compression therapy over no compression therapy to increase venous leg ulcer healing rate and to decrease the risk of ulcer recurrence. [GRADE - 1; LEVEL OF EVIDENCE - B] Guideline 4.2: Compression after superficial vein treatment in patients with a mixed arterial and venous leg ulcer. In a patient with a venous leg ulcer and underlying arterial disease, we suggest limiting the use of compression to patients with ankle-brachial index exceeding 0.5 or if absolute ankle pressure is >60 mm Hg. [GRADE - 2; LEVEL OF EVIDENCE - C]. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jvsv.2018.10.002 PMID: 30554745
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Venous Ulcers - Overview