The Optimal Duration of Compression Therapy Following Varicose Vein Surgery: A Meta-analysis of Randomized Controlled Trials

Objective: The optimal duration of compression therapy following varicose vein surgery of the great saphenous vein (GSV) remains controversial. Therefore, the aim of this study was to evaluate different durations of compression therapy after varicose vein surgery and their outcomes. Design: A systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: Outcomes from short-duration (3-10 d) and long-duration (3-6 wk) compression therapy after GSV stripping and phlebectomies were evaluated. Pain was assessed post surgery using a visual analog scale. Secondary outcomes included leg volume, complications, and the duration of absenteeism from work. Results: We identified 4 RCTs published between 1991 and 2009 that evaluated 686 patients. We observed nonsignificant differences in postoperative pain scores between the long-duration and short-duration groups, with a weighted mean difference of -0.03 (95% confidence interval (Cl): -0.53 to 0.47) at 4 weeks, and -0.01 (95% Cl: -0.31 to 0.33) at 6 weeks, postoperatively. We also observed non-significant differences in the incidence of postoperative complications (risk ratio: 0.84, 95% Cl: 0.60-1.18), and changes in leg volume, 4 weeks postoperatively (P = .18) between the groups. Conclusion: Our study results indicate that there are no benefits to long-term compression therapy after varicose vein surgery of the GSV regarding postoperative pain, leg volume, incidence of complications, and duration of absenteeism from work. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.