Varicose vein surgery is a common procedure used to treat venous insufficiency and remove enlarged veins. Following any treatment, the use of compression stockings is a mandatory part of the post-operative regimen. Applying external pressure to the legs is an immediate measure designed to optimize surgical results and minimize potential complications. The goal of this compression therapy is to support the treated veins and surrounding tissues as they heal.
The Purpose of Post-Surgical Compression
Compression stockings serve a direct physiological function in the post-operative period by assisting the body’s circulatory system. The external pressure immediately helps to reduce post-operative swelling, known as edema, by limiting fluid leakage from blood vessels into surrounding tissues. This reduction in fluid accumulation also helps to minimize bruising, or hematoma formation, a common side effect following vein procedures.
By squeezing superficial veins, the stockings force blood to reroute into deeper veins, improving venous return toward the heart. This enhanced blood flow is directly responsible for decreasing the risk of blood clots, including the serious complication of Deep Vein Thrombosis (DVT). Consistent compression use also reduces post-procedure pain and discomfort, allowing for a quicker return to normal daily activities. The gentle pressure supports the closed vein walls, which is beneficial after procedures designed to seal malfunctioning vessels.
Recommended Timelines Based on Procedure Type
The duration for wearing compression stockings varies depending on the specific technique used, reflecting the procedure’s invasiveness. For common minimally invasive treatments, like Endovenous Laser Ablation (EVLA) or Radiofrequency Ablation (RFA), the standard protocol involves continuous wear (day and night) for the first 48 to 72 hours. This initial period is when the sealing of the treated vein is most critical and the risk of immediate swelling is highest. Following this phase, patients transition to daytime-only wear for an additional one to three weeks.
Procedures involving the physical removal of veins through tiny incisions, such as Ambulatory Phlebectomy, require a similar but sometimes longer period of compression. Patients are asked to keep the stockings on continuously for the first week to support incision sites and manage localized swelling and bruising. After the first week, the daytime-only regimen continues for two to four weeks total, depending on the extent of vein removal. The pressure is essential to keep the vein tunnels closed and the skin firm against the underlying tissue.
Sclerotherapy, which involves injecting a chemical solution to collapse smaller veins, requires the shortest compression timeline. Continuous wear is often mandated only for the first one to seven days, followed by daytime wear for one to two weeks. The compression ensures the chemically irritated vein walls remain collapsed and seal effectively, maximizing the procedure’s success. These are general guidelines, and the exact timing is always dictated by the treating surgeon based on the individual patient’s health and the complexity of their procedure.
Selecting the Right Stocking Pressure and Fit
The compression stockings used after surgery are medical-grade garments, differing significantly from standard over-the-counter support hose. These medical devices apply a precise amount of pressure, measured in millimeters of mercury (mmHg), and possess a graduated compression design. This means the stocking is tightest at the ankle and gradually becomes less restrictive as it moves up the calf and thigh, mechanically assisting the upward flow of blood toward the heart.
For post-surgical recovery, the prescribed compression level is Class I (20-30 mmHg) or Class II (30-40 mmHg). The 20-30 mmHg level is the most common and effective for managing moderate swelling and preventing blood clots. Higher pressure may be used for patients with more extensive disease or a greater risk of complication. Due to precise pressure requirements, medical-grade stockings necessitate a professional fitting to ensure the correct size and gradient are applied. A poorly fitting stocking, particularly one that bunches or rolls down, can create a tourniquet effect, potentially hindering circulation rather than helping it, underscoring the need for prescription and proper measurement.
Recognizing Signs of Complete Recovery
The decision to discontinue compression stockings should always be made in consultation with the surgeon, not abruptly by the patient. Complete recovery is indicated by symptomatic and visual signs confirming the treated veins have successfully sealed and surrounding tissues have healed. The most obvious indicator is the complete resolution of post-operative edema, meaning the treated leg no longer experiences noticeable swelling.
Visually, the bruising and localized tenderness that follow the procedure should have faded or disappeared entirely. Any small skin incisions should be fully closed and no longer exhibit warmth, redness, or discharge, which are signs of infection. The surgeon often confirms the treatment’s success and vein stability through a follow-up ultrasound scan before giving final clearance. The final step often involves a gradual reduction, such as wearing the stockings for fewer hours per day, rather than an immediate cessation, to allow the body to fully adjust to the lack of external support.