Use of a needleless injection system for digital ring block anesthesia.

Digital ring block anesthesia, which is frequently used before surgery for ingrown toenails, is often extremely uncomfortable for patients and can be the most distressing aspect of the procedure. The authors used a novel needleless injection device to induce digital anesthesia before surgery and compared it in terms of patient discomfort and preference with use of a standard needle and syringe for injection in individuals undergoing simultaneous bilateral nail procedures. Use of the needleless device significantly reduced the pain associated with this procedure and was preferred over use of a standard needle and syringe by all individuals.

Primary varicose veins: the sapheno-femoral junction, distribution of varicosities and patterns of incompetence.

Objective: to determine the patterns of long saphenous vein (LSV) disease in primary varicose veins (VVs).

Design: a retrospective analysis of venous duplex scans performed on patients referred for treatment of primary VVs.

Methods: analysis was made of sapheno-femoral junction (SFJ) incompetence, non-SFJ incompetence, segmental and perforating vein incompetence, distribution of varicosities, deep venous insufficiency, and short saphenous incompetence.