Preparing for Varicose Vein Surgery in Hospital

Why this pre-operative guide matters

The decision to have varicose veins treated involves planning and a few simple precautions that greatly increase safety and comfort throughout. When you know what to do from the day before through to the post-operative follow-up, the day of surgery is calmer, the risk of surprises drops, and recovery is faster.

In this guide from Clínica Fluxo you will find:

• How to prepare on the eve of the surgery (fasting, shaving, skin hygiene);
• What to do on the day of admission and how to use the chlorhexidine sponge;
• How hospital admission and the anaesthetist's assessment work;
• What to expect from the immediate post-operative period;
• Rules for rest, movement and home care;
• Warning signs and when to contact the team;
• Frequently asked questions about varicose vein surgery.

Our goal is for you to arrive at the hospital confident, knowing step by step what to do.

1. The eve of the surgery: shaving, hygiene and fasting

Shaving the genital area and the legs

On the night before the surgery, follow these instructions (unless your doctor has told you otherwise):

• Areas to shave: the whole groin area and the entire lower limb area.
• Method:
  • Clipper/trimmer: the safest option for the skin;
  • Razor: can be done the night before, taking care not to cut the skin;
  • Wax: if you choose hot or cold waxing, the ideal is to do it at least 3 days beforehand, to reduce irritation, redness and the risk of folliculitis.
• Avoid:
  • Shaving at the last moment with aggressive methods, which can cause micro-wounds;
  • Depilatory creams if you have had a previous allergy or irritation.

Any wound, skin infection, fungal infection or significant inflammation may lead the team to postpone the surgery. If you notice anything unusual on your skin, tell the clinic before the scheduled day.

Fasting: when it starts and what is allowed

Fasting is one of the most important parts of the preparation for anaesthesia.

• When fasting starts: it must begin 8 hours before the scheduled time of surgery. For example, if your surgery is at 7 am on Friday, fasting starts between 9 pm and 11 pm on Thursday.
• During the fast: do not consume any solid food or liquid (including water, coffee, tea, milk, juice, sweets, chewing gum, alcoholic drinks).
• Medication during the fast: if you need a regular medication in that period, tell the surgeon or the clinic team beforehand. You will receive specific instructions (whether to take it, postpone it or adjust the dose). If you use a weight-loss injectable (Ozempic, Wegovy, Mounjaro or Saxenda), it is important that you tell the doctor.

An empty stomach reduces the risk of respiratory complications during anaesthesia and is an essential safety measure.

2. Day of admission: shower, chlorhexidine and what to bring

Shower and use of the chlorhexidine solution

On the day of admission, before leaving for the hospital, take a careful shower and use the chlorhexidine sponge as instructed:

• Take your usual shower with a neutral soap.
• After the shower, still in the shower stall, apply the chlorhexidine sponge:
  • Rub the sponge over the legs for a few minutes, from the thigh towards the feet, until the solution covers the whole leg and foot;
  • Rinse thoroughly to remove the excess solution and chlorhexidine;
  • Dry yourself with a clean towel, without rubbing hard on the leg area.

Chlorhexidine helps reduce germs on the skin and lowers the risk of infection of the surgical wound.

Essential medication on the day

• Important continuous-use medication (such as anti-hypertensives, hormones, thyroid medication, and so on) should be taken up to the night before, or, if your doctor has said so, on the morning of surgery with only half a small cup of water (approximately 25 ml).
• If you have any doubt about which medicine to keep or suspend, contact the team before the day of the procedure.

What to bring to the hospital

On the day of admission, bring:

• The prescribed anti-thrombosis stocking: the stocking is STERILE and must only be opened by the medical team. Do not open the packaging at home.
• Pre-operative tests (original or printed copies, as requested): blood tests; Doppler ultrasound; cardiology assessment (or electrocardiogram and chest X-ray); any other tests your doctor has requested.
• Documents: identification document; health insurance card (if you have one); signed informed consent forms; any other forms or authorisations required by the hospital.

Organise everything in one folder to make the check at admission easier.

3. Admission and anaesthetic assessment

Arriving at the hospital

• You should be admitted on the day and time advised by the Clínica Fluxo nursing team (or by specific instruction from the hospital), bringing all the requested tests and documents.
• After admission, you will be taken to your room, suite, or directly to the pre-surgical unit.

The anaesthetist's assessment

In the surgical centre (or still in your room):

• The anaesthetist will:
  • Talk to you, reviewing your history, allergies and medication;
  • Confirm how long you have been fasting;
  • Explain the types of anaesthesia available and which is most suitable for your case.
• The anaesthetics most used for varicose vein surgery are:
  • Spinal block (spinal anaesthesia), very common in these cases;
  • General anaesthesia, in special and selected situations;
  • Local anaesthesia, in even less frequent cases.
• Who performs the anaesthesia: in most cases the procedure is conducted by an anaesthetist from the medical staff of the hospital where you will be operated on.

4. After varicose vein surgery: what has changed and what to expect

The post-operative period of varicose vein surgery has evolved a great deal in recent years. Today, the focus is:

• Early mobilisation: walk and move as soon as possible, always respecting your condition;
• Fast return to routine activities, within the limits of comfort;
• Rest as comfort, not as a rigid obligation.

The old idea that "if you break the rest, the varicose veins come back" is a myth with no scientific basis.

Degree of pain and type of incisions

• Most varicose vein surgeries are not very painful:
  • The incisions are superficial;
  • Most are millimetres in size;
  • When the saphenous veins need to be treated, we prefer the technique recommended as the gold standard: varicose vein surgery with endolaser. If the saphenous veins or large varicose veins have to be removed, the cuts need stitches.
• Each person, however, has their own pain threshold. Some feel more discomfort than others, but in general simple painkillers are enough to control it.

Endovascular techniques

• In some situations endovascular techniques are used, such as:
  • Endovenous laser;
  • Radiofrequency.

In these cases the rest period is usually even shorter. Your vascular surgeon will explain which technique will be used and give you written and verbal instructions specific to your case.

General rules for rest and movement

These instructions generally apply to the first week after surgery, up to the first follow-up, unless your doctor makes personalised adjustments.

Bed position and movement in bed

• Raising the bed
  • If possible, wedge the foot of the bed up to a maximum height of 10 cm, so that the feet sit slightly higher.
  • From the seventh day, the bed can return to its original height.
• Simple exercises in bed
  • While lying down, make movements to:
    • Stretch and contract your legs;
    • Bend and extend your feet (as if you were accelerating a car).
  • These movements help pump the blood and stop it from stagnating in the deep veins of the calf, reducing the risk of thrombosis.

Alternating rest and walking

• First week after surgery
  • Until the first follow-up, follow this pattern:
  • About 20 minutes lying down or sitting, with your legs extended; alternated with 10 to 15 minutes of walking inside the house.
  • This alternation helps circulation, reduces swelling and eases discomfort.
• When you are standing
  • Avoid standing still in the same position for long periods;
  • Try to move as if you were walking normally, even over short distances.
• Stairs
  • You may use stairs, as long as:
  • It is not a large number of steps;
  • It is done calmly, at a slow pace, respecting tiredness and pain.

5. Dressings, prevention of venous thromboembolism (VTE) and showering

• Prevention of venous thromboembolism:
  • For most patients a graduated anti-thrombosis stocking is prescribed. It is put on in the surgical centre and must stay on for at least 24 hours after the surgery, as instructed by the team.
  • A thromboembolism risk assessment is carried out, and in some cases prophylactic medication for VTE may be needed for a few days.
• Showering after surgery
  • On the following day, once the bandages are removed, you may shower.
  • After it is removed, the anti-thrombosis stocking can be hand-washed carefully and should be worn once dry, as instructed, until the medical follow-up. You may wear it continuously, taking it off only to shower or to wash it.
• Discharge medication
  • Take the medicines as prescribed on your discharge note, respecting doses and times (painkillers, anti-inflammatories, antibiotics, etc., if prescribed).
• Micropore strips (small tapes over the incisions)
  • If there are micropore strips over the cuts, they should be removed 24 hours after the surgery;
  • The ideal is to remove them dry, as they usually come off more easily.

6. Follow-up with the team

• The follow-up appointment
  • Return for reassessment on the day and place given in your discharge instructions.
  • On average this follow-up takes place 5 to 10 days after discharge, but follow the specific date given by your doctor.
  • At the follow-up we assess:
    • Dressings and healing;
    • Presence of bruising;
    • Adaptation to the compression stocking;
    • Whether the instructions need adjusting.

General questions

• If you have any doubt, contact the clinic.
• If you cannot reach the clinic, go to the emergency department of the place where the procedure was performed.
• Avoid following advice from lay people, neighbours or non-medical sources. Your surgeon and the team are the best source of information for your case.

Frequently asked questions about varicose vein surgery