Peter Chapman-Smith
Dr Peter Chapman-Smith is a full time specialist Phebologist and Appearance Medicine physician, who has performed over 1500 Endovenous Laser Ablation (EVLA) and over 15000 Ultrasound Guided Sclerotherapy (UGS) procedures in the treatment of varicose veins since 1992. A Foundation Fellow of the NZ College of Appearance Medicine and of the Australasian College of Phebology, also a Fellow of the Medical Faculty of the Australasian College of Cosmetic Surgery, and of the RNZCGP. He has extensive experience of skin lasers and IPL, performs liposuction under tumescent anaesthesia, and provides regular skin cancer and minor cosmetic surgery and photodynamic therapy. A regular international presenter on nonsurgical vein treatment, a published researcher and teacher . He is an Affiliated Provider for Southern Cross Healthcare for nonsurgical varicose vein treatment and for skin cancer surgery, with regular clinics in Whangarei, Hibiscus Coast and Queenstown. Director of the Skin and Vein Clinic, and teacher of GP surgical techniques in NZ. Dr Peter Chapman-Smith Skin and Vein Clinic doctor@skinandvein.co.nz Phone 0800 1 4 VEINS
Myths About Leg Veins and Ulcers Nurses Programme Saturday, 14 June 2014 Start 11:30am Duration: 30mins Sportsdrome Varicose veins affect 40-50% of the population, cause significant discomfort and poor quality of life, yet are frequently under diagnosed and under treated. Men and women are similarly affected. Obesity , grand multiparity, less active occupations, and a genetic predisposition are relevant causative factors. Pick your parents well! Leg ulcers are common, and 80% of these are caused by varicose veins. The public health financial cost is between 2-6% of the health spend in most western countries, 1-2% of Vote Health in NZ. Personal costs are lack of mobility, with smelly and perhaps secondarily infected chronic ulcers grumbling on for many years. A non healing skin wound for over 2 weeks is an ulcer by definition. Modern treatment of varicose veins is nonsurgical, after appropriate assessment and a duplex ultrasound study to define the vein sizes, flow and anatomy. Endovenous thermal laser ablation (EVLA) with usually a long wavelength laser, using tumescent perivenous local anesthesia alone, allows ready resolution of symptoms and restores normal venous circulation. Foam sclerotherapy under US guidance (UGS) is essential to treat all downstream and branch refluxing veins as well. Any size of vein can be treated, being shrunk to approximately 2mm diameter pre EVLA by the perivenous infiltration of fluid. Patients walk in and walk out, can drive home immediately, and return to home or work duties the same day. Avoiding numerous surgical scars, and the risks of GAs is desirable. EVLA is first line gold standard treatment in the public system in Canada and Australia currently. Surprisingly there are few contraindications to EVLA or UGS. Obese, anticoagulated, diabetic or haemodialising patients can be treated safely. Very recent cardiac instability or pregnancy are contraindications. They are well tolerated procedures by young and old. Venous leg ulcers may recur, especially if only healed temporarily with dressings alone. Ulcers heal readily if you treat the underlying cause. Initial healing is dependent on treating the chronic venous hypertension, wearing adequate compression hose constantly until ulcers are healed ( maybe for many weeks), and addressing comorbidity as obesity. Educating carers and patients with a consistent message from all health providers assists outcomes. Venous surgery has not been shown to affect recurrence rates, with a far higher published VTE rate. Common indicative symptoms of varicose veins are heavy tired or hot legs that may itch, cramps or burning pain, restless legs syndrome, and sx are worse often with heat, standing or menses. Prolonged sitting with VVS can lead to DVT or PE – worse with inherited thrombophilia.