Phlebology
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Since 2009 the National Health Service (NHS) has been collecting patient-reported outcome measures (PROMs) following varicose vein interventions. The objective of this manuscript was to interrogate the one-year PROMs data with respect to varicose vein intervention and to discuss its potential impact on the provision of service. ⋯ These data have shown variable improvements following venous interventions. PROMs are likely to have significant implications for health care in the NHS on a number of levels including provision of funding and future planning of services.
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Despite the fact that venous thromboembolism (VTE) is one of the most widely studied areas in medicine, and despite the availability of data from numerous RCTs, there are many areas where the evidence is insufficient to allow grade A recommendations to be made. In these areas published guidelines often differ in their advice. In this chapter we primarily discuss the National Institute of Clinical and Health Excellence (NICE) VTE prophylaxis pathways in the context of other guidance published by the Scottish Intercollegiate Guideline Network and the American Colleges of Physicians and Chest Physicians. Evidence for the use of both mechanical and pharmacological thromboprophylaxis is discussed for both medical and surgical patients.
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Clinical Trial
An observational study for venous thromboembolism risk assessment among hospitalized patients in general surgery clinics across Turkey.
Venous thromboembolism (VTE) still remains a significant public health problem due to gaps between recommendations and clinical practice in VTE prophylaxis. This is the first clinical study designed to evaluate the applicability of a standard 'VTE prophylaxis and risk factor assessment form (VTE-PRAF)' and prescription of VTE prophylaxis among hospitalized patients in the daily practice of general surgeons in Turkey. ⋯ Based on the use of prophylaxis only for 65.9% of general surgery inpatients at high risk for VTE, low use of prophylaxis is assumed to remain a significant threat to public health across Turkey. Inclusion of a standard VTE-PRAF in the hospital protocol seems to raise clinical awareness of VTE risk assessment and appropriate management in VTE which otherwise well-known to be associated with significant mortality and morbidity. Impact of e-VTE-PRAF is worth investigating.
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Randomized Controlled Trial Multicenter Study Comparative Study
Tumescent anaesthesia in combination with femoral nerve block for surgery of varicose veins: prilocaine 0.1% versus 0.2%.
Results of a prospective, randomized, double-blinded study about tumescent anaesthesia (TA) in combination with femoral nerve block (FNB) for surgery of varicose veins are reported. The aim is to compare two different concentrations of prilocaine in TA. ⋯ TA with prilocaine 0.1% in combination with FNB is sufficient to provide high patient satisfaction during varicosis surgery.