PURPOSE
Cosmetic Improvement of the hands has been a relatively neglected area in the field of plastic surgery. Large dorsal veins give an aged look to otherwise attractive hands.
The safety and efficacy of injection compression sclerotherapy (ICS) for the treatment of leg veins has been recognized for many decades. Our study was undertaken to determine the effectiveness and morbidity of ICS in the treatment of dorsal hand veins.
METHODS
Two hundred and eight patients who underwent bilateral hand vein ICS were studied.  Each patient was seen at least twice, and all treatment was done without any anesthetic or sedation. All injections were done using Only FDA approved sclerosants (sodium tetradecol sulfate).
At the first office visit, as many dorsal hand veins as possible were treated.  All treatment was done in-office on an outpatient basis. Injection sites were covered with cotton pledgets and held in place using surgical tape. At least one vein was preserved in each hand to facilitate intravenous therapy should it be required in the future.
At the second visit most patients required additional ICS for veins not treated originally. Where a prominent thrombus had developed in a treated vein, needle aspiration of the thrombus was done to expedite cosmetic improvement, but most thrombi were left in place for eventual resorption by the natural processes. Some visits were merely follow-up evaluations where neither ICS nor thrombus evacuation was necessary.
EXPERIENCE
The success of hand vein ICS in restoring a youthful look to the dorsum of the hand has been outstanding. Often, cosmetic improvement was seen shortly after treatment.  All the patients have been able to leave our offices right after therapy, drive themselves home, and resume normal daily activities. The treatments have been uniformly free of late changes in hand function. There were no serious complications, i. e. anaphylaxis, ulceration, pulmonary emboli or infection. Short-term post therapy disturbances were limited to localized edema and bruising and always resolved in a matter of days. There were no treatment failures.

While it is difficult to exactly quantify the percentage of cosmetic improvement, the level of patient satisfaction has been very high.

SUMMARY/CONCLUSION

ICS to eliminate dorsal hand veins is an extremely safe office procedure with virtually no early or late problems. Cosmetic improvement is dramatic, as will be documented in before and after photographs of hand vein patients.

PATIENT PHOTOS

Patient 1) Pre-therapy          Patient 1) Post-therapy

Patient 2) Pre-therapy          Patient 2) Post-therapy

 
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