Perforation-Invagination (PIN) Stripping of the Long Saphenous Vein Reduces Thigh Haematoma Formation in Varicose Vein Surgery

Abstract

Objective: To compare the extent of thigh haematoma formation after perforation-invagination (PIN) stripping with that occurring after standard plication stripping of the long saphenous vein. Design: Prospective, within-case, randomised study with analysis on an intention-to-treat basis. Setting: The radioisotope department of a university teaching hospital. Patients: Fourteen patients undergoing bilateral varicose vein surgery. Interventions: Red blood cell labelling in vivo with 99Tcm. Preoperative imaging of the long saphenous vein using a gamma camera. Randomisation of one leg to PIN stripping and the other to standard stripping of the long saphenous vein to the knee. Patients were reimaged 6 h postoperatively. Main outcome measures: The extent of thigh haematoma formation. Results: There was no significant difference with respect to the severity of varicosities in the long saphenous vein in the thigh between the limbs assigned to each group ( n = 11) on the preoperative images ( T = 25, 0.5> p>0.1, Wilcoxon signed rank test). Thigh haematoma in the limbs that had undergone PIN stripping of the long saphenous vein was significantly less than that in the limbs that had undergone standard stripping (T = 10, 0.05> p>0.01, Wilcoxon signed rank test). Conclusion: PIN stripping of the long saphenous vein results in significantly decreased haematoma formation compared with standard stripping.