6 steps to prevent phlebitis
This article will allow us to take stock of one of the possible complications following WAL liposuction, lipedema surgery: phlebitis.
First of all, what is the definition of phlebitis or venous thrombosis?
Avenous thrombosisis a blood clot that forms in a vein.
It most often affects the lower limbs and occurs in:
- a deep vein (deep vein thrombosis)
- superficial vein (superficial phlebitis or paraphlebitis).
This complication must be taken seriously because it can lead to complications that are sometimes serious, particularlypulmonary embolism.
What are the symptoms?
Venous thrombosis is generally characterized by three symptoms:
- A redness
- Edema
- Pain (usually in the calf)
These signs are not always present, nor are they very specific; in fact, the postoperative period following lipedema surgery is characterized by pain in the operated areas and significant edema. Since phlebitis is generally unilateral, it is important to be vigilant when these symptoms are more pronounced on one side. It can also cause a slight fever.
But it is also important to remember that phlebitis can be asymptomatic!
What factors increase this risk?
Venous insufficiency
It is characterized by a faulty venous network, which makes it difficult for blood to return to the deep network. It is a common condition, affecting between 15 and 20 million people in France, particularly women.
It most often manifests itself as:
- The feeling of heavy legs,
- The presence of telangiectasias (blue or purple veins beneath the surface of the skin), or even varicose veins (dilated veins beneath the skin that have become swollen and twisted).
If you have varicose veins, it is important to have them treated by a phlebologist at least two months before undergoing WAL liposuction performed byDr. Nicolas Zwillinger, a lipedema specialist in France.
Blood hypercoagulability
It promotes clot formation by disrupting the blood coagulation system. It may be due to a genetic predisposition (constitutional thrombophilia), such as a congenital deficiency in certain coagulation factors (protein S, protein C, antithrombin).
Hypercoagulability can also occur in certain circumstances: pregnancy, obesity, smoking, and advanced age promote thrombus formation.
Certain medications, such as hormonal contraceptives or corticosteroids, also increase this risk.
The preoperative blood test and the preoperative appointment withthe anesthesiologistwill allow us to assess these risks of hypercoagulability, and if the risk is too high, the procedure may be canceled.
Our 6 tips for avoiding phlebitis after lipedema surgery?
1. Postoperative compression
We recommend double compression with class 3 compression stockings + BIFLEX bandages (day and night) for 5 to 10 days, followed by single compression with class 3 compression stockings + BIFLEX bandages for an additional 3 weeks.
This double compression is an important factor in preventing this post-surgical complication in legs affected by lipedema.
2. LOVENOX injections
To reduce the risk of venous thrombosis, you will be prescribed an anticoagulant injection (LOVENOX) for 10 days, at a rate of one injection per day.
This injection is administered at the clinic on the day of the procedure (at the end of the day) and must be administered at a fixed time throughout the treatment. You will be given a prescription for these injections to be administered by a home nurse, but it is also possible to administer them yourself.
Here are the steps to follow:
Disinfection of the injection site
Removal of the protective cap
- Pinch the injection site
- Inject by placing the syringe vertically.
- Product injection
- Automatic protection system
- It is important to alternate injection sites: upper thighs or stomach. It is normal to see a small bruise appear at the injection sites.
3. Walking
Walking improves venous return, and you will be able to walk on the day of your procedure. You will walk slowly and cover short distances at first, but you will gradually increase the distance over the days following the procedure.
We advise you to remain active (walk around your home) and not to overexert yourself during the first few days. One week after the procedure, you will be able to walk longer distances. It is strongly advised not to remain in bed for several days after the procedure in order to avoid post-operative venous thrombosis.
4. Quitting smoking
As tobacco increases hypercoagulability, it is strongly recommendedthat you stop smoking(or using nicotine substitutes) one month before and up to one month after the procedure. Feel free to start quitting smoking several months before the procedure.
5. Drink plenty of water
Staying well hydrated promotes good blood flow and thus reduces the risk of post-operative phlebitis. It is recommended that you drink at least 1.5 to 2 liters of water per day for 10 to 15 days.
However, we recommend avoiding tea, which prevents iron absorption.
6. A follow-up examination: Doppler ultrasound
Despite all of these recommendations, phlebitis following WAL liposuction surgery is still possible.
In order to monitor this risk, you will be given a prescription for a Doppler ultrasound scan.
The angiologists performing this check-up will be able to tell you after the examination whether you have venous thrombosis and, if so, prescribe a longer course of anticoagulant treatment and continued compression (usually double compression).
This article provides a better understanding of what phlebitis is and how to avoid this complication by following our six tips for preventing venous thrombosis after lipedema surgery.