Varicose veins are obvious, dilated veins just under the skin. In normal veins the valves make sure blood only moves in one direction. The valves in varicose veins are faulty, allowing blood to pool and the veins to enlarge. This can cause aching legs, itching and poor cosmetic appearance. People with varicose veins may wear compression stockings, have an injection of irritant substance to close the veins under the skin (sclerotherapy), or have the veins removed surgically. There is a potential for large blood loss during surgery, especially if both legs are operated on at the same time. Tourniquets on the upper leg during surgery may be useful to minimise blood loss.
This review found that the amount of blood loss was clearly reduced when a tourniquet was used during surgery for varicose veins, with no overall increase in operative time, reported adverse events or change in patient reported pain and activity after surgery. Three trials were included in the review, in which a total of 176 men and women (211 legs) were randomised to either use or non-use of a tourniquet. All trials took place in the UK between 1989 and 2000. Those patients who did not have a tourniquet had a wider range of total blood loss and patients in the upper limits lost a significant amount of blood. A reduction in blood loss may also result in a reduction in post-operative bruising but only one of the trials (50 patients) looked at this. It found a clear reduction in the area of bruising with the use of a tourniquet. The trials did not have a large enough number of participants to determine any rarer complications of surgery with the use of a tourniquet such as nerve damage or arterial injury, especially in older patients.