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Online ISSN 1827-1766
Meloni V., Bosco M. R., Fabbri F., Ferrarta G., Vietri F., Gioffrè L.
Università degli Studi di Roma, «La Sapienza» - Roma, Dipartimento di Scienze Chirurgiche e Tecnologie Mediche Applicate
Intra and/or postoperative bleeding, with bruising and/or hematoma formation, is the most common complication after stripping of the long saphenous vein. Generally moderate, this bleeding can increase and, in presence of direct incompetent perforating veins or of other different causes, the bleeding along the passage of stripper can fill the saphenic channel. This space, circumscribed from a superficial fascia’s duplication and also known as “saphenic eye” from its ultrasound typical image, can sequestrate the blood which may developed a cord-shaped, fibrous, organized hematoma, sometimes accompanied by a light pigmented stripe, looking as the “phantom” of the resected vein. In order to prevent these complications the introduction is suggested, in selected cases, of a suction-drain in the saphenic channel. This is carried out minimizing surgical wounds along the limb, recovering stripper from groin incision and using it — with a procedure borrowed from vascular radiology-like a guide-wire to insert a Redon drain inside the saphenic channel. Results have been good and enabled, in a preliminary series of l0 patients, to drain in the first 24 hours a significative amount of blood (mean: 70 cc) without hematomas and bruising reduction. The authors discuss other intra-and postoperative methods reported in the literature, and outline the specific effectiveness of their method in obese patients, with disharmonic limbs, or with direct incompetent perforators on the stripper passage.