Some complications from surgery in varicose veins.

This paper deals with some selected complications of operation. The majority arise from technical faults and errors in judgement or documentation. My choice of topics here has been for their immediate treatment and the avoidance and aftercare of the others. Wrong technique. Combined operations resulting in damage to important adjacent structures: a) arteries: divisions, ligations, stripping; veins: ligation, tearing, avulsion of saphena femoral junction; b) nerves: division, femoral, lateral popliteal, cutaneous; c) lymphatics: particularly in recurrent operations, lymphoma and subsequent oedema; d) skin: particularly incisions through thickened skin, inflammatory skin, oedematous skin; e) connective tissues. Major complications. Haemorrhage, shock, problems with skin closure, methods of dressings, post-operative immediate, anaesthetic problems. Haemorrhage, haematoma, swelling, oedema, lymphatic deep vein thrombosis, pulmonary embolism (1 in 3000--fatal 1 in 30,000). Wound healing, skin necrosis, wound infection. Leg complications: persistent varicose veins, recurrent varicose veins, pain, nerve palsies, chronic oedema.