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Superficial Thrombophlebitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

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68 pages48 minutes

Summary

This book describes Superficial Thrombophlebitis, Diagnosis and Treatment and Related Diseases
Thrombophlebitis is an inflamed distended vein due to a blood clot.
Superficial indicates that the veins are just below the skin's surface.
Superficial thrombophlebitis happens when a superficial vein (normally the long saphenous vein of the leg or its tributaries) becomes inflamed and the blood inside it clots.
It may be spontaneous or linked with one or more risk factors - e.g., varicose veins.
It is normally a benign self-limiting disease but it can be complicated to treat and slow to resolve
Causes
This disorder may happen after damage to the vein.
Or it may happen following the giving the medicines given into the veins
The three cardinal risk factors (Virchow's triad) are:
1. Injury to the blood vessel wall (as a result of trauma, infection, or inflammation).
2. Stasis of blood flow.
3. Hyper-coagulability of blood.
Other specific risk factors are:
1. Obesity.
2. Thrombophilia.
3. Smoking.
4. Oral contraceptives.
5. Pregnancy
6. Intravenous drug abuse.
Symptoms
There are numerous different manifestations of superficial thrombophlebitis:
1. Superficial thrombophlebitis normally happens in the lower limbs (greater saphenous vein) but happens also in the penis and the breast (Mondor's disease).
2. Traumatic thrombophlebitis accompanies an injury or during intravenous injection
There is a tender hard cord along the course of a injured or varicose vein and bruising
A small lump may appear days or weeks after the injection needle has been removed and it can take months to resolve completely
There is:
1. Skin redness, tenderness, or pain along a vein just below the skin, and inflammation,
2. Warmth of the area
3. Limb pain
4. Hardening of the vein
Diagnosis
The doctor will diagnose this disorder based mainly on the appearance of the involved vein.
Ultrasound of the blood vessels helps substantiate the disorder.
If there are signs of an infection, skin or blood cultures may be done.
Treatment

General measures
Elastic support of the limb decreases swelling and relieves discomfort.
The affected extremity should be raised if possible and large, warm compresses may be applied, even though the evidence for their success is limited and care must be taken to prevent burning the patient
Exercise decreases pain and the probability of DVT.
Only in patients in whom pain is very severe is bed rest required.
Pharmacological

The topical analgesia with non-steroidal anti-inflammatory creams used locally to the superficial vein thrombosis/superficial thrombophlebitis area stops symptoms.
Hirudoid cream (heparinoid) reduces the duration of signs/symptoms
An intermediate dose of low molecular weight heparin for at least a month might be advised
Fondaparinux at a dose of 2.5 mg once a day for 45 days has been documented to lower the danger of pulmonary embolism (PE) or DVT by 85%.
Antibiotics are only needed if there is presence of infection
Surgical
If there are repeat occurrences of the thrombophlebitis linked with extensive varicose veins, they should be excised and ligated
There is a need for surgical resection (phlebectomy), stripping or sclerotherapy of the affected vein.
These treat large varicose veins.
A painful segment of a superficial vein containing a palpable intravascular blood clot may be treated by puncture incision with an 18-gauge needle and evacuation of the clot under local anesthesia.
With septic disorder, appropriate antibiotics should be given.
If suppurative thrombophlebitis is indicated, immediate and complete excision of all of the affected veins is indicated.
The wound may be left open for drainage of pus.

TABLE OF CONTENT
Introduction
Chapter 1 Superficial Thrombophlebitis
Chapter 2 Causes

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