Accidents in the surgical treatment of varicose veins.

Serious accidents in the surgical treatment of varices are quite exceptional and it is impossible to say with any accuracy how often they occur. Generally they result from major errors of surgical technique, and arise mainly from: haemorrhaging after the tearing of the femoral vein or because of the loosening of the stump of the saphenofemoral junction, traumatism of the femoral artery, damage of the nervus peronaeus in crossectomy of the saphena parva. Minor accidents are more frequent but here too it is impossible to state a precise percentage. There are four fairly common types of accident: serious haematoma following a stripping, which can be avoided by ligation of the accessible collaterals. Trendelenburg's peroperative position, aspiration drainage, and elastic compression; phlebitis, usually superficial and at the level of appendage clusters on the trunk of the saphenal vein, but sometimes deep: much rarer, this has not been observed once in 2335 cases of surgery of the long saphenous vein, and only three times in 583 cases of surgery performed either on the short saphenous vein alone, or on both saphenae; oedema of lymphatic origin to be observed particularly after operations on recurrent cases but sometimes after initial surgery too: in the case of pre-existing lymphatic abnormality or in the case of multiple incisions, especially internal crural incisions; painful paresthesia of saphenal nerves which, as a general rule, regress spontaneously.