Randomised clinical trial of the duration of compression therapy after varicose vein surgery

Objective. To determine whether a period of one or three weeks of compression following varicose vein surgery influenced the outcome. Design. Randomised controlled trial. Method. 300 patients aged between 18-80 years underwent unilateral varicose vein surgery in a Day Procedure Unit. Compression bandaging was applied post-operatively for three days. Patients then wore graduated elastic compression stockings randomised to a period of either one or three weeks. Patients were assessed by questionnaire on pain scores at rest and during mobilisation for up to six weeks, total analgesic consumption, duration of time off work, any complications, and patient perception of cosmetic results at various periods up to 12 weeks following surgery. Results. The mean pain score reported by patients over 6 weeks was similar in the two groups (1 week group: mean 2.18, three week group: mean 1.87). The 95% confidence interval (CI) for the mean difference in pain was (-0.05-0.66). Analysis of the pain curves at I week, 4 weeks and 6 weeks, showed equivalence at 4 and 6 weeks, but not for 1 week, with the group wearing stockings for only one week complaining of more pain for this period. A significant increase in the total number of analgesia tablets consumed was also found in the group wearing stockings for only one week. No significant differences were found in the other secondary endpoints - return to work (categorised as < 2 weeks, 2-6 weeks or 6-12 weeks), patient satisfaction or post-operative complications. Conclusion. We found no benefit in wearing compression stockings for more than one week following uncomplicated high saphenous ligation with stripping of the great saphenous vein with respect to post-operative pain, number of complications, time to return to work, or patient satisfaction for up to 12 weeks following surgery.