Until such time as the exact thromboplastic effect of the oral contraceptive tablet has been established, it is advisable not to use sclerotherapy on patients who are currently taking oral contraceptives.
|b.||Inability to walk|
As the recommended treatment involves daily periods of walking by the patient it is not advisable to embark upon treatment if for any reason the patient cannot walk at least 4½ kilometres each day.
It is recommended that patients with obese legs should not receive treatment. In many cases this obesity may be corrected by dieting, after which time treatment may be commenced.
|d.||Any known allergy to Sodium tetradecyl sulphate|
Treatment by injection of S.T.D. should not be continued if an allergic reaction has been experienced after a previous injection of Sodium tetradecyl sulphate.
|e.||Acute superficial thrombophlebitis or arterial disease|
S.T.D. should not be used where there is thrombosis of the deep veins of the leg, acute phlebitis or other affections in the region of the varices.
|f.||Local or systemic infection.|
|g.||Varicosities caused by pelvic or abdominal tumours.|
|h.||Uncontrolled systemic disease e.g. diabetes mellitus.|
|i.||Significant valvular incompetence requiring surgical treatment.|
|1.||Allergy and Anaphylaxis|
|a.||History of allergy should be taken from all patients prior to treatment. In particular allergic reactions to previous injections of Sodium tetradecyl sulphate should be noted (see Contra-indications above).|
|b.||A higher incidence of allergic reactions is thought to result from repeated treatment involving Sodium tetradecyl sulphate Injection and may involve intervals of several years between courses of injections.|
|Equipment for treatment of anaphylaxis|
|The treatment of anaphylaxis may require, depending on severity of attack, some or all of the following: Injection of adrenaline, Injection of hydrocortisone, Antihistamine injection, Endotracheal tube, laryngoscope, Mucus extraction pump. The treatment of varicose veins by S.T.D. Injection should not be undertaken if these items are not readily available.|
|2.||Use in pregnancy and lactation|
|Safety for use in pregnancy has not been established. Use only when clearly needed for symptomatic relief and when the potential benefits outweigh the potential hazards to the foetus.|
|It is not known whether S.T.D. is excreted in human milk. Caution should be exercised when used in nursing mothers.|
|3.||Extreme caution in use is required in patients with arterial disease such as severe peripheral atherosclerosis of thromboangiitis obliterans (Buerger's disease).|
|4.||The in-use period of each multidose vial is a single session of therapy and for use in the treatment of a single patient. Unused vial contents should be discarded immediately after use.|
|1.||Introducing the sclerosant into this vein after it has been emptied. Extreme care in the needle placement and slow injection of minimal effective volume at each injection site are essential for safe and efficient use.|
|2.||Maintaining the sclerosant in the empty and isolated segment for 30 seconds.|
|3.||Applying compression immediately to the site of injection, maintaining it for a period of about 6 weeks, until one is quite sure that, when the patient stands erect, the internal pressure of the blood in the adjacent unobliterated vein cannot reopen the segment.|
|4.||Applications of compression is most suitable obtained by firm bandaging with a number of strong cotton crepe bandages and by incorporating therein shaped rubber pads over the sites of injection. An elastic stocking applied over the bandages aids compression and the retention of bandages in position.|