The Clinical Efficacy of Evidence-Based Nursing in Surgery for Lower Extremity Varicose Veins

The Clinical Efficacy of Evidence-Based Nursing in Surgery for Lower Extremity Varicose Veins | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Clinical Efficacy of Evidence-Based Nursing in Surgery for Lower Extremity Varicose Veins Zhuoxian Zhu, Ying Shi, Yifan Chen, Yajuan Li This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6459287/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study evaluated clinical efficacy of evidence-based nursing (EBN) care in the management of LEVV after surgery. A prospective non-randomized controlled trial enrolled 60 CEAP C2-C4 patients (2024), allocated to EBN (n = 30) or conventional care (n = 30). The EBN intervention featured: JBI-based preoperative education with animated demonstrations; Hemodynamic-guided stepwise compression therapy; WeChat-delivered rehabilitation addressing ambulation hesitancy. Primary outcomes included perioperative period complications, 3-month Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ). Analyses used SPSS 26.0 with t-tests and chi-square (α = 0.05). The EBN group demonstrated a significant reduction in subcutaneous hematomas (2 vs. 8 cases, P = 0.038), 5-fold lower limb edema incidence (1 vs. 6 cases, P = 0.044), a superior VCSS improvement (5.16 ± 0.85 vs. 7.29 ± 0.69, P = 0.031), a higher CIVIQ scores (79.44 ± 9.54 vs. 70.20 ± 9.46, P = 0.024) and a satisfaction rate (93.3% vs. 70.0%, P = 0.02) as compared to Control group. This study substantiates that evidence-based nursing transcends conventional perioperative care by systematically addressing biomechanical and behavioral of LEVV recovery. Health sciences/Health care/Quality of life Health sciences/Diseases/Cardiovascular diseases/Vascular diseases/Peripheral vascular disease Evidence-Based Nursing Surgery Lower Extremity Varicose Veins Figures Figure 1 INTRODUCTION Lower extremity varicose veins (LEVV), a chronic venous disorder caused by venous valve dysfunction, affects approximately 10%-40% of the global population [ 1 , 2 ] . In China, the prevalence has reached 10–20% with an emerging trend of younger onset [ 3 ] . Pathologically characterized by tortuous dilation of superficial veins, cutaneous hyperpigmentation, and refractory ulcers (CEAP classification C2-C6), this condition leads to persistent pain, mobility impairment, social avoidance behaviors, and reduced health-related quality of life (HRQoL) [ 4 ] . Surgical intervention remains the primary approach for moderate-to-severe LEVV, encompassing both conventional high ligation and stripping of the great saphenous vein (GSV-HLS) and minimally invasive techniques such as radiofrequency ablation of the great saphenous vein (GSV-RA). Nevertheless, postoperative complications persist at 15%-22%, including deep vein thrombosis (DVT), incisional infections, and subcutaneous hematomas [ 5 ] . Systematic reviews indicate that 67.4% of postoperative DVT cases correlate with non-compliance with activity guidance [ 6 ] , while subcutaneous hematoma occurrence demonstrates direct associations with deviations in compression therapy protocols and suboptimal compliance with elastic stocking regimens [ 7 ] . The conventional perioperative care model demonstrates notable limitations: it predominantly relies on empirical practices (e.g., standardized elastic bandage compression protocols) without hemodynamic evidence-based individualized protocols, while simultaneously neglecting behavioral-psychological determinants such as non-adherence to compression therapy and fear of early ambulation, ultimately contributing to delayed recovery trajectories [ 8 ] . Research reveals that merely 68% of patients achieve proper elastic stocking application, with preoperative anxiety levels correlating with a 30% increase in postoperative pain perception [ 9 ] . Evidence-Based Nursing (EBN), which integrates best available research evidence, clinical expertise, and patient value preferences, demonstrates distinct advantages in optimizing perioperative management [ 10 ] . For instance, in joint arthroplasty, stratified anticoagulation protocols based on the Caprini risk assessment model have shown a 23% reduction in deep vein thrombosis incidence [ 11 ] . Current challenges in varicose vein surgery nursing reveal three critical gaps: Guideline-Practice Discrepancy: International guidelines [ 4 ] provide insufficient granular operational standards for compression therapy and pain management, resulting in fragmented nursing implementations. Innovation-Adaptation Lag: Emerging minimally invasive techniques like CHIVA (Conservative Hemodynamic Cure for Venous Insufficiency) necessitate precision hemodynamic management protocols, yet prevailing nursing strategies predominantly adhere to legacy intervention models from traditional vein stripping procedures. Contextual Evidence Deficiency: Chinese-specific factors – including therapeutic misconceptions (e.g., "tighter compression yields better outcomes" regarding elastic stockings) and cultural preferences (e.g., reluctance towards early postoperative ambulation) – remain unintegrated into clinical pathway development. Comprehensive evaluation of EBN implementation in LEVV surgeries is imperative to address these systemic challenges. MATERIALS AND METHODS All methods were carried out in accordance with relevant guidelines and regulations. All experimental protocols were approved by an institutional committee of First People’s Hospital of Jiashan County. Study Design This prospective non-randomized controlled trial enrolled 60 patients diagnosed with lower extremity varicose veins (LEVV) in 2024. Participants were allocated into two groups: the evidence-based nursing (EBN) group (experimental group, n = 30) and the conventional care group (control group, n = 30). Participants Inclusion criteria: 1) LEVV patients classified as CEAP C2-C4 requiring surgical intervention. 2)Age 18–70 years. 3)Provision of written informed consent Exclusion criteria: 1) Severe cardiopulmonary comorbidities. 2)Coagulation disorders. 3)Cognitive impairments. 4)Pregnancy Interventions Control group Received standard perioperative care, including preoperative education, postoperative vital sign monitoring, and routine wound dressing. Experimental group Implemented an EBN protocol comprising Preoperative phase Individualized education program based on the JBI Evidence-Based Practice Database, incorporating animated demonstrations of minimally invasive procedures and compression therapy adherence training. Intraoperative phase Collaborative temperature preservation strategies with the anesthesia team (evidence-based interventions to reduce infection risks). Postoperative phase : Stepwise compression therapy: Elastic stocking pressure adjustments guided by clinical guidelines. Multimodal analgesia: Protocol-driven pain management based on Numerical Rating Scale (NRS) scores. Continuing care: Functional exercise videos delivered via WeChat platform. Weekly follow-ups to assess compression therapy adherence. Primary endpoints: Postoperative pain intensity at 72 hours (Visual Analog Scale, VAS), incidence of complications (deep vein thrombosis, surgical site infections, subcutaneous hematomas) and length of hospital stay. Functional recovery: Venous Clinical Severity Score (VCSS) at 3 months postoperatively. Quality of life: Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ) scores (preoperative and 3-month postoperative). Satisfaction: Patient-reported satisfaction with treatment and follow-up care, categorized as "very satisfied," "satisfied," or "dissatisfied." Statistical Analysis Data analysis was performed using SPSS 26.0. Continuous variables were expressed as mean ± standard deviation (SD) and analyzed with Student's t-test. Categorical variables were reported as frequencies (%) and evaluated using the Chi-square test. A two-tailed P-value < 0.05 was considered statistically significant. RESULTS Baseline Characteristics As demonstrated in Table 1 , no statistically significant differences were observed between the two groups in age, gender distribution, preoperative clinical symptoms, CEAP classification, or baseline Venous Clinical Severity Score (VCSS) (all P > 0.05). Table 1 Baseline Characteristics Items Experimental group Control group p Sex(female) 10/30 7/30 0.390 Age(years) 53.83 ± 16.28 52.76 ± 14.84 0.645 CEAP classification 2 12 11 0.791 3 8 10 0.573 4 10 9 0.781 Swelling of the legs 22 20 0.573 Heaviness in the legs 18 23 0.165 Cramps 11 8 0.405 Skin pigmentation 12 17 0.196 CIVIQ, preoperative 52.33 ± 8.26 52.33 ± 8.26 0.571 VCSS, preoperative 20.03 ± 1.67 19.98 ± 1.84 0.616 CIVIQ: Chronic Venous Insufficiency Quality of Life Questionnaire. VCSS: Venous Clinical Severity Score Primary Outcomes In Table 2 , the experimental group exhibited significantly lower incidence rates of postoperative lower limb edema (1/30 vs. 6/30, P = 0.044) and subcutaneous hematomas (2/30 vs. 8/30, P = 0.038) compared to the control group. However, no significant intergroup differences were observed in mean hospital stay, deep vein thrombosis (DVT) incidence, pigmentation improvement, leg cramps, or limb heaviness (P > 0.05 for all). Table 2 Complication Items Experimental group Control group p Hospital time 5.14 ± 0.87 5.22 ± 0.85 0.671 Swelling of the legs 1 6 0.044 Heaviness in the legs 2 6 0.129 Cramps 0 1 0.313 Pigmentation improvement 13 10 0.426 Subcutaneous hematoma 2 8 0.038 Subcutaneous nodules 3 7 0.166 DVT 0 2 0.472 CIVIQ, postoperative 79.44 ± 9.54 * 70.20 ± 9.46 * 0.024 VCSS, postoperative 5.16 ± 0.85 7.29 ± 0.69 * 0.031 CIVIQ: Chronic Venous Insufficiency Quality of Life Questionnaire. VCSS: Venous Clinical Severity Score Functional Recovery At the 3-month follow-up, the experimental group demonstrated superior improvement in VCSS scores compared to controls (5.16 ± 0.85 vs. 7.29 ± 0.69, P = 0.031) as disclosed in Table 2 . Quality of Life In Table 2 , significantly greater improvement in Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ) total scores was observed in the experimental group (79.44 ± 9.54 vs. 70.20 ± 9.46, P = 0.024). Patient Satisfaction As showing in Fig. 1 , satisfaction rates with postoperative care and health management were significantly higher in the experimental group (28/30 [93.3%] vs. 21/30 [70.0%], P = 0.02). DISSCUSSION This study demonstrates the clinical superiority of evidence-based nursing (EBN) over conventional care in perioperative management for lower extremity varicose vein (LEVV) surgery. The integration of individualized education, precision interventions, and culturally adapted protocols significantly reduced postoperative complications while enhancing functional recovery and quality of life—findings that address critical gaps in current venous surgery care paradigms. Complication Reduction and Mechanistic Insights The study showed 20% reduction in subcutaneous hematoma incidence (2/30 vs. 8/30, P = 0.038) and 16.7% lower limb edema rates (1/30 vs. 6/30, P = 0.044) in the EBN group align with existing evidence highlighting compression therapy adherence as a critical determinant of postoperative outcomes [ 12 ] . The EBN protocol’s emphasis on preoperative compression technique training—reinforced by animated visual aids and weekly adherence monitoring—likely mitigated improper stocking application, a prevalent issue affecting lots of patients in conventional care settings [ 9 ] . Notably, the absence of significant differences in DVT incidence (P > 0.05) may reflect insufficient power due to sample size limitations, though it also suggests the need for enhanced thromboprophylaxis strategies, such as integrating Caprini risk stratification into postoperative mobilization protocols [ 13 ] . Functional Recovery and Quality of Life The EBN group’s superior improvement in VCSS (5.16 ± 0.85 vs. 7.29 ± 0.69, P = 0.031) and CIVIQ scores (79.44 ± 9.54 vs. 70.20 ± 9.46, P = 0.024) highlights the synergistic effects of structured rehabilitation. WeChat-delivered functional exercise videos addressed cultural hesitancy toward early ambulation, a key barrier in Chinese populations, by providing culturally congruent, home-based rehabilitation guidance. This aligns with studies demonstrating technology-enhanced follow-up care improves self-efficacy in chronic disease management [ 14 ] Satisfaction The 93.3% satisfaction rate in the EBN group reflects successful integration of Chinese-specific factors: Cognitive calibration: Animation-based education corrected the "tighter-is-better" compression misconception; Behavioral scaffolding: Weekly WeChat follow-ups overcame cultural reluctance toward early ambulation. All them disclosed that EBN practice achieved better care experience and postoperative adherence than Contral group for possible pain improvement and reduced complications [ 15 ] . Limitations and Future Directions While this study provides compelling evidence for EBN efficacy, several limitations warrant consideration. The non-randomized design introduces potential selection bias, though baseline homogeneity (P > 0.05) mitigates this concern. The single-center setting and 3-month follow-up period limit generalizability and preclude assessment of long-term recurrence rates. Future multicenter randomized trials should validate these findings across diverse healthcare contexts and extend follow-up to 12 months to evaluate durability. Additionally, incorporating wearable sensors for real-time monitoring of compression adherence and ambulation patterns could further optimize EBN protocols. CONCLUSION This trial substantiates that evidence-based nursing transcends conventional perioperative care by systematically addressing biomechanical and behavioral of LEVV recovery. The protocol’s success in harmonizing international guidelines with localized patient needs establishes a replicable framework for surgical nursing innovation. As minimally invasive techniques and patient-centered care models evolve, embedding EBN principles into clinical pathways will be critical to achieving precision care in venous disease management. Declarations Author Contribution Conception and design: Zhuoxian Zhu and Yajuan LiAnalysis and interpretation: Zhuoxian Zhu, Ying ShiData collection: Zhuoxian Zhu, Ying Shi, Yifan ChenWriting the article: Zhuoxian ZhuCritical revision of the article: Zhuoxian Zhu and Yajuan LiFinal approval of the article: Zhuoxian Zhu, Ying Shi, Yifan Chen, Yajuan LiObtained funding: Not applicableOverall responsibility: Zhuoxian Zhu and Yajuan Li Data Availability All data generated or analyzed during this study is included in this published article and its supplementary information files. References Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez, & Quesada F (2012). Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 31(2):105-15. [PMID: 22466974] Beebe-Dimmer JL, Pfeifer JR, Engle JS, & Schottenfeld D (2005). The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol; 15(3):175-84. doi: 10.1016/j.annepidem.2004.05.015. [PMID: 15723761]. Jiang W, Liang Y, Long Z, Hu M, Yang H, & Qin X (2024). Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis. J Vasc Surg Venous Lymphat Disord. 1 12(5):101842. doi: 10.1016/j.jvsv.2024.101842. [PMID: 38316290] Gloviczki P, Lawrence PF, Wasan SM, Meissner MH, Almeida J, Brown KR, Bush RL, Di Iorio M, Fish J, Fukaya E, Gloviczki ML, Hingorani A, Jayaraj A, Kolluri R, Murad MH, Obi AT, Ozsvath KJ, Singh MJ, Vayuvegula S, &Welch HJ (2024). The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascula.J Vasc Surg Venous Lymphat Disord. 12(1):101670. doi: 10.1016/j.jvsv.2023.08.011. [PMID: 37652254] Farah MH, Nayfeh T, Urtecho M, Hasan B, Amin M, Sen I, Wang Z, Prokop LJ, Lawrence PF, Gloviczki P, & Murad MH (2024). A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins. 10(5):1155-1171.doi: 10.1016/j.jvsv.2021.08.011. [PMID: 34450355] Wang H, Sun Z, Jiang W, Zhang Y, Li X, &Wu Y. Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV). Vasc Med. 20(2):117-21. doi: 10.1177/1358863X14564592. [PMID: 25601917] Chen P, Chen H, Yang M. Comparison of high ligation of great saphenous vein using pneumatic tourniquets and conventional method for great saphenous vein varicosis. Medicine (Baltimore). 2020; 28:e21975. Franz A, Wann-Hansson C. Patients' experiences of living with varicose veins and management of the disease in daily life. J Clin Nurs.2016; 25:733-41. Gong JM, Du JS, Han DM, Wang XY, Qi SL. Reasons for patient non-compliance with compression stockings as a treatment for varicose veins in the lower limbs: A qualitative study. PLoS One. 2020; 28;15: e0231218. Chen Q, Halili X, Castro AR, Zhao J, Chen W, et al. Differences in evidence-based nursing practice competencies of clinical and academic nurses in China and opportunities for complementary collaborations: A cross-sectional study. J Clin Nurs. 2023; 32: 3695-3706. Cheng D, Long X, Li W. Effect of evidence-based nursing on lower limb thrombosis and negative emotion after hip arthroplasty. Minerva Surg. 2023;78:459-461. Coelho F, Araújo WJB, Belczak S, Rui EF, Borsato BB, et al. Influence of compression therapy following varicose vein surgery: a prospective randomized study. J Vasc Bras. 2023; 22: e20220052. Di Gangi S, Guillet C, Anzengruber F, Zechmann S, Meier TO. Deep vein thrombosis after sclerotherapy and endovenous laser ablation of varicose veins - an observational study. Vasa. 2024;53:275-285. Caggiati A, De Maeseneer M, Cavezzi A, Mosti G, Morrison N. Rehabilitation of patients with venous diseases of the lower limbs: State of the art. Phlebology. 2018; 33:663-671. Zhang XL, Wang CY, Pan LL, Li YJ. Effects of evidence-based nursing care interventions on wound pain and wound complications following surgery for finger tendon injury. Int Wound J. 2024; 21: e14818. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6459287","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":505768677,"identity":"ce636e4a-b7fb-4f0e-baa4-b0ff4dd58d15","order_by":0,"name":"Zhuoxian Zhu","email":"","orcid":"","institution":"The First People’s Hospital of Jiashan County","correspondingAuthor":false,"prefix":"","firstName":"Zhuoxian","middleName":"","lastName":"Zhu","suffix":""},{"id":505768678,"identity":"8a5cfdc0-b3ea-4709-8b28-1a5be2613d2d","order_by":1,"name":"Ying Shi","email":"","orcid":"","institution":"The First People’s Hospital of Jiashan County","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Shi","suffix":""},{"id":505768679,"identity":"247dd873-7de0-433f-b3ac-599ea8c96d87","order_by":2,"name":"Yifan Chen","email":"","orcid":"","institution":"The First People’s Hospital of Jiashan County","correspondingAuthor":false,"prefix":"","firstName":"Yifan","middleName":"","lastName":"Chen","suffix":""},{"id":505768680,"identity":"c84eace2-ec1f-4444-9cba-dcaacd55e1f1","order_by":3,"name":"Yajuan Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIie3RsQrCMBCA4SuBTNWsEcW+QoqgCD5MgpBNcOwgmEHaQcW1voWjY1ToFHF1cKiLs90cbWelrZtD/jkfl0sAbLY/DHuXp+ZsNN+QTZbyYFZNmhT89BlIZxvrHktNUk26FHp+bI7OTvF+675ANS7WVrLdCDVioGUgFAYSLXk56egkJzc8QCq5in0HqDnvygmIMCcPd6gO4VUYDIxOqsgY5+REmR7jqQhRDUIlytc/MaZlMbEOcY1TPDJvxQZRbhK3chcvWkHxlZyQlZO9glmXROty8pH723GbzWazfe0NY39NOBSsRwcAAAAASUVORK5CYII=","orcid":"","institution":"The First People’s Hospital of Jiashan County. Jiaxing","correspondingAuthor":true,"prefix":"","firstName":"Yajuan","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2025-04-16 04:08:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6459287/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6459287/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90312889,"identity":"ba68ab1e-3fd2-4cba-b206-27bb875483d8","added_by":"auto","created_at":"2025-09-01 10:04:47","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":46825,"visible":true,"origin":"","legend":"\u003cp\u003ePatient-reported satisfaction with treatment and follow-up care. The asterisk symbol (*) denotes a statistically significant difference (p \u0026lt; 0.05).\u003c/p\u003e","description":"","filename":"file.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6459287/v1/aec704cbd7c4d415b614df37.jpg"},{"id":96482094,"identity":"15ccb146-f942-41aa-907b-4e6775ed2209","added_by":"auto","created_at":"2025-11-21 15:09:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":613743,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6459287/v1/a076a09a-ca05-43b9-a009-d3c0d83dee6a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Clinical Efficacy of Evidence-Based Nursing in Surgery for Lower Extremity Varicose Veins","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eLower extremity varicose veins (LEVV), a chronic venous disorder caused by venous valve dysfunction, affects approximately 10%-40% of the global population \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. In China, the prevalence has reached 10\u0026ndash;20% with an emerging trend of younger onset \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Pathologically characterized by tortuous dilation of superficial veins, cutaneous hyperpigmentation, and refractory ulcers (CEAP classification C2-C6), this condition leads to persistent pain, mobility impairment, social avoidance behaviors, and reduced health-related quality of life (HRQoL) \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eSurgical intervention remains the primary approach for moderate-to-severe LEVV, encompassing both conventional high ligation and stripping of the great saphenous vein (GSV-HLS) and minimally invasive techniques such as radiofrequency ablation of the great saphenous vein (GSV-RA). Nevertheless, postoperative complications persist at 15%-22%, including deep vein thrombosis (DVT), incisional infections, and subcutaneous hematomas \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Systematic reviews indicate that 67.4% of postoperative DVT cases correlate with non-compliance with activity guidance\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e, while subcutaneous hematoma occurrence demonstrates direct associations with deviations in compression therapy protocols and suboptimal compliance with elastic stocking regimens \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe conventional perioperative care model demonstrates notable limitations: it predominantly relies on empirical practices (e.g., standardized elastic bandage compression protocols) without hemodynamic evidence-based individualized protocols, while simultaneously neglecting behavioral-psychological determinants such as non-adherence to compression therapy and fear of early ambulation, ultimately contributing to delayed recovery trajectories \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Research reveals that merely 68% of patients achieve proper elastic stocking application, with preoperative anxiety levels correlating with a 30% increase in postoperative pain perception \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eEvidence-Based Nursing (EBN), which integrates best available research evidence, clinical expertise, and patient value preferences, demonstrates distinct advantages in optimizing perioperative management \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. For instance, in joint arthroplasty, stratified anticoagulation protocols based on the Caprini risk assessment model have shown a 23% reduction in deep vein thrombosis incidence \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Current challenges in varicose vein surgery nursing reveal three critical gaps: Guideline-Practice Discrepancy: International guidelines \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e provide insufficient granular operational standards for compression therapy and pain management, resulting in fragmented nursing implementations. Innovation-Adaptation Lag: Emerging minimally invasive techniques like CHIVA (Conservative Hemodynamic Cure for Venous Insufficiency) necessitate precision hemodynamic management protocols, yet prevailing nursing strategies predominantly adhere to legacy intervention models from traditional vein stripping procedures. Contextual Evidence Deficiency: Chinese-specific factors \u0026ndash; including therapeutic misconceptions (e.g., \"tighter compression yields better outcomes\" regarding elastic stockings) and cultural preferences (e.g., reluctance towards early postoperative ambulation) \u0026ndash; remain unintegrated into clinical pathway development.\u003c/p\u003e\u003cp\u003eComprehensive evaluation of EBN implementation in LEVV surgeries is imperative to address these systemic challenges.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e All methods were carried out in accordance with relevant guidelines and regulations. All experimental protocols were approved by an institutional committee of First People\u0026rsquo;s Hospital of Jiashan County.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design\u003c/h2\u003e\u003cp\u003eThis prospective non-randomized controlled trial enrolled 60 patients diagnosed with lower extremity varicose veins (LEVV) in 2024. Participants were allocated into two groups: the evidence-based nursing (EBN) group (experimental group, n\u0026thinsp;=\u0026thinsp;30) and the conventional care group (control group, n\u0026thinsp;=\u0026thinsp;30).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eInclusion criteria: 1) LEVV patients classified as CEAP C2-C4 requiring surgical intervention. 2)Age 18\u0026ndash;70 years. 3)Provision of written informed consent\u003c/p\u003e\u003cp\u003eExclusion criteria: 1) Severe cardiopulmonary comorbidities. 2)Coagulation disorders. 3)Cognitive impairments. 4)Pregnancy\u003c/p\u003e\n\u003ch3\u003eInterventions\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eControl group\u003c/strong\u003e\u003cp\u003eReceived standard perioperative care, including preoperative education, postoperative vital sign monitoring, and routine wound dressing.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExperimental group\u003c/strong\u003e\u003cp\u003eImplemented an EBN protocol comprising\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003ePreoperative phase\u003c/strong\u003e\u003cp\u003eIndividualized education program based on the JBI Evidence-Based Practice Database, incorporating animated demonstrations of minimally invasive procedures and compression therapy adherence training.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eIntraoperative phase\u003c/strong\u003e\u003cp\u003eCollaborative temperature preservation strategies with the anesthesia team (evidence-based interventions to reduce infection risks).\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003ePostoperative phase\u003c/b\u003e: Stepwise compression therapy: Elastic stocking pressure adjustments guided by clinical guidelines.\u003c/p\u003e\u003cp\u003eMultimodal analgesia: Protocol-driven pain management based on Numerical Rating Scale (NRS) scores.\u003c/p\u003e\u003cp\u003eContinuing care: Functional exercise videos delivered via WeChat platform. Weekly follow-ups to assess compression therapy adherence.\u003c/p\u003e\n\u003ch3\u003ePrimary endpoints:\u003c/h3\u003e\n\u003cp\u003ePostoperative pain intensity at 72 hours (Visual Analog Scale, VAS), incidence of complications (deep vein thrombosis, surgical site infections, subcutaneous hematomas) and length of hospital stay.\u003c/p\u003e\u003cp\u003eFunctional recovery: Venous Clinical Severity Score (VCSS) at 3 months postoperatively.\u003c/p\u003e\u003cp\u003eQuality of life: Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ) scores (preoperative and 3-month postoperative).\u003c/p\u003e\u003cp\u003eSatisfaction: Patient-reported satisfaction with treatment and follow-up care, categorized as \"very satisfied,\" \"satisfied,\" or \"dissatisfied.\"\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eData analysis was performed using SPSS 26.0. Continuous variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and analyzed with Student's t-test. Categorical variables were reported as frequencies (%) and evaluated using the Chi-square test. A two-tailed P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eBaseline Characteristics\u003c/h2\u003e\u003cp\u003eAs demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, no statistically significant differences were observed between the two groups in age, gender distribution, preoperative clinical symptoms, CEAP classification, or baseline Venous Clinical Severity Score (VCSS) (all P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBaseline Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExperimental group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex(female)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10/30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7/30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.390\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge(years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53.83\u0026thinsp;\u0026plusmn;\u0026thinsp;16.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52.76\u0026thinsp;\u0026plusmn;\u0026thinsp;14.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.645\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCEAP classification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.791\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.573\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.781\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSwelling of the legs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.573\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeaviness in the legs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCramps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.405\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkin pigmentation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.196\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCIVIQ, preoperative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e52.33\u0026thinsp;\u0026plusmn;\u0026thinsp;8.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52.33\u0026thinsp;\u0026plusmn;\u0026thinsp;8.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.571\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVCSS, preoperative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.98\u0026thinsp;\u0026plusmn;\u0026thinsp;1.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.616\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eCIVIQ: Chronic Venous Insufficiency Quality of Life Questionnaire. VCSS: Venous Clinical Severity Score\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePrimary Outcomes\u003c/h3\u003e\n\u003cp\u003eIn Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the experimental group exhibited significantly lower incidence rates of postoperative lower limb edema (1/30 vs. 6/30, P\u0026thinsp;=\u0026thinsp;0.044) and subcutaneous hematomas (2/30 vs. 8/30, P\u0026thinsp;=\u0026thinsp;0.038) compared to the control group. However, no significant intergroup differences were observed in mean hospital stay, deep vein thrombosis (DVT) incidence, pigmentation improvement, leg cramps, or limb heaviness (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComplication\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExperimental group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHospital time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.671\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSwelling of the legs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.044\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeaviness in the legs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.129\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCramps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.313\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePigmentation improvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.426\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubcutaneous hematoma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubcutaneous nodules\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.166\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDVT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.472\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCIVIQ, postoperative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.54 *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e70.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.46 *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVCSS, postoperative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69 *\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.031\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eCIVIQ: Chronic Venous Insufficiency Quality of Life Questionnaire. VCSS: Venous Clinical Severity Score\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eFunctional Recovery\u003c/h2\u003e\u003cp\u003eAt the 3-month follow-up, the experimental group demonstrated superior improvement in VCSS scores compared to controls (5.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85 vs. 7.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69, P\u0026thinsp;=\u0026thinsp;0.031) as disclosed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eQuality of Life\u003c/h2\u003e\u003cp\u003eIn Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, significantly greater improvement in Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ) total scores was observed in the experimental group (79.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.54 vs. 70.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.46, P\u0026thinsp;=\u0026thinsp;0.024).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003ePatient Satisfaction\u003c/h2\u003e\u003cp\u003eAs showing in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, satisfaction rates with postoperative care and health management were significantly higher in the experimental group (28/30 [93.3%] vs. 21/30 [70.0%], P\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"DISSCUSSION","content":"\u003cp\u003eThis study demonstrates the clinical superiority of evidence-based nursing (EBN) over conventional care in perioperative management for lower extremity varicose vein (LEVV) surgery. The integration of individualized education, precision interventions, and culturally adapted protocols significantly reduced postoperative complications while enhancing functional recovery and quality of life\u0026mdash;findings that address critical gaps in current venous surgery care paradigms.\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eComplication Reduction and Mechanistic Insights\u003c/h2\u003e\u003cp\u003eThe study showed 20% reduction in subcutaneous hematoma incidence (2/30 vs. 8/30, P\u0026thinsp;=\u0026thinsp;0.038) and 16.7% lower limb edema rates (1/30 vs. 6/30, P\u0026thinsp;=\u0026thinsp;0.044) in the EBN group align with existing evidence highlighting compression therapy adherence as a critical determinant of postoperative outcomes \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. The EBN protocol\u0026rsquo;s emphasis on preoperative compression technique training\u0026mdash;reinforced by animated visual aids and weekly adherence monitoring\u0026mdash;likely mitigated improper stocking application, a prevalent issue affecting lots of patients in conventional care settings \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. Notably, the absence of significant differences in DVT incidence (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) may reflect insufficient power due to sample size limitations, though it also suggests the need for enhanced thromboprophylaxis strategies, such as integrating Caprini risk stratification into postoperative mobilization protocols \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eFunctional Recovery and Quality of Life\u003c/h2\u003e\u003cp\u003eThe EBN group\u0026rsquo;s superior improvement in VCSS (5.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85 vs. 7.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69, P\u0026thinsp;=\u0026thinsp;0.031) and CIVIQ scores (79.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.54 vs. 70.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.46, P\u0026thinsp;=\u0026thinsp;0.024) highlights the synergistic effects of structured rehabilitation. WeChat-delivered functional exercise videos addressed cultural hesitancy toward early ambulation, a key barrier in Chinese populations, by providing culturally congruent, home-based rehabilitation guidance. This aligns with studies demonstrating technology-enhanced follow-up care improves self-efficacy in chronic disease management \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eSatisfaction\u003c/h2\u003e\u003cp\u003eThe 93.3% satisfaction rate in the EBN group reflects successful integration of Chinese-specific factors: Cognitive calibration: Animation-based education corrected the \"tighter-is-better\" compression misconception; Behavioral scaffolding: Weekly WeChat follow-ups overcame cultural reluctance toward early ambulation. All them disclosed that EBN practice achieved better care experience and postoperative adherence than Contral group for possible pain improvement and reduced complications \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e\u003cp\u003eWhile this study provides compelling evidence for EBN efficacy, several limitations warrant consideration. The non-randomized design introduces potential selection bias, though baseline homogeneity (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) mitigates this concern. The single-center setting and 3-month follow-up period limit generalizability and preclude assessment of long-term recurrence rates. Future multicenter randomized trials should validate these findings across diverse healthcare contexts and extend follow-up to 12 months to evaluate durability. Additionally, incorporating wearable sensors for real-time monitoring of compression adherence and ambulation patterns could further optimize EBN protocols.\u003c/p\u003e\u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis trial substantiates that evidence-based nursing transcends conventional perioperative care by systematically addressing biomechanical and behavioral of LEVV recovery. The protocol\u0026rsquo;s success in harmonizing international guidelines with localized patient needs establishes a replicable framework for surgical nursing innovation. As minimally invasive techniques and patient-centered care models evolve, embedding EBN principles into clinical pathways will be critical to achieving precision care in venous disease management.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConception and design: Zhuoxian Zhu and Yajuan LiAnalysis and interpretation: Zhuoxian Zhu, Ying ShiData collection: Zhuoxian Zhu, Ying Shi, Yifan ChenWriting the article: Zhuoxian ZhuCritical revision of the article: Zhuoxian Zhu and Yajuan LiFinal approval of the article: Zhuoxian Zhu, Ying Shi, Yifan Chen, Yajuan LiObtained funding: Not applicableOverall responsibility: Zhuoxian Zhu and Yajuan Li\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data generated or analyzed during this study is included in this published article and its supplementary information files.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eRabe E, Guex JJ, Puskas A, Scuderi A, Fernandez, \u0026amp; Quesada F (2012). Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 31(2):105-15. [PMID: 22466974]\u003c/li\u003e\n\u003cli\u003eBeebe-Dimmer JL, Pfeifer JR, Engle JS, \u0026amp; Schottenfeld D (2005). The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol; 15(3):175-84. doi: 10.1016/j.annepidem.2004.05.015. [PMID: 15723761].\u003c/li\u003e\n\u003cli\u003eJiang W, Liang Y, Long Z, Hu M, Yang H, \u0026amp; Qin X (2024). Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis. J Vasc Surg Venous Lymphat Disord. 1 12(5):101842. doi: 10.1016/j.jvsv.2024.101842. [PMID: 38316290]\u003c/li\u003e\n\u003cli\u003eGloviczki P, Lawrence PF, Wasan SM, Meissner MH, Almeida J, Brown KR, Bush RL, Di Iorio M, Fish J, Fukaya E, Gloviczki ML, Hingorani A, Jayaraj A, Kolluri R, Murad MH, Obi AT, Ozsvath KJ, Singh MJ, Vayuvegula S, \u0026amp;Welch HJ (2024). The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: Endorsed by the Society of Interventional Radiology and the Society for Vascula.J Vasc Surg Venous Lymphat Disord. 12(1):101670. doi: 10.1016/j.jvsv.2023.08.011. [PMID: 37652254]\u003c/li\u003e\n\u003cli\u003eFarah MH, Nayfeh T, Urtecho M, Hasan B, Amin M, Sen I, Wang Z, Prokop LJ, Lawrence PF, Gloviczki P, \u0026amp; Murad MH (2024). A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins. 10(5):1155-1171.doi: 10.1016/j.jvsv.2021.08.011. [PMID: 34450355]\u003c/li\u003e\n\u003cli\u003eWang H, Sun Z, Jiang W, Zhang Y, Li X, \u0026amp;Wu Y. Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV). Vasc Med. 20(2):117-21. doi: 10.1177/1358863X14564592. [PMID: 25601917]\u003c/li\u003e\n\u003cli\u003eChen P, Chen H, Yang M. Comparison of high ligation of great saphenous vein using pneumatic tourniquets and conventional method for great saphenous vein varicosis. Medicine (Baltimore). 2020; 28:e21975.\u003c/li\u003e\n\u003cli\u003eFranz A, Wann-Hansson C. Patients\u0026apos; experiences of living with varicose veins and management of the disease in daily life. J Clin Nurs.2016; 25:733-41.\u003c/li\u003e\n\u003cli\u003eGong JM, Du JS, Han DM, Wang XY, Qi SL. Reasons for patient non-compliance with compression stockings as a treatment for varicose veins in the lower limbs: A qualitative study. PLoS One. 2020; 28;15: e0231218.\u003c/li\u003e\n\u003cli\u003eChen Q, Halili X, Castro AR, Zhao J, Chen W, et al. Differences in evidence-based nursing practice competencies of clinical and academic nurses in China and opportunities for complementary collaborations: A cross-sectional study. J Clin Nurs. 2023; 32: 3695-3706.\u003c/li\u003e\n\u003cli\u003eCheng D, Long X, Li W. Effect of evidence-based nursing on lower limb thrombosis and negative emotion after hip arthroplasty. Minerva Surg. 2023;78:459-461.\u003c/li\u003e\n\u003cli\u003eCoelho F, Ara\u0026uacute;jo WJB, Belczak S, Rui EF, Borsato BB, et al. Influence of compression therapy following varicose vein surgery: a prospective randomized study. J Vasc Bras. 2023; 22: e20220052. \u003c/li\u003e\n\u003cli\u003eDi Gangi S, Guillet C, Anzengruber F, Zechmann S, Meier TO. Deep vein thrombosis after sclerotherapy and endovenous laser ablation of varicose veins - an observational study. Vasa. 2024;53:275-285.\u003c/li\u003e\n\u003cli\u003eCaggiati A, De Maeseneer M, Cavezzi A, Mosti G, Morrison N. Rehabilitation of patients with venous diseases of the lower limbs: State of the art. Phlebology. 2018; 33:663-671.\u003c/li\u003e\n\u003cli\u003eZhang XL, Wang CY, Pan LL, Li YJ. Effects of evidence-based nursing care interventions on wound pain and wound complications following surgery for finger tendon injury. Int Wound J. 2024; 21: e14818.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Evidence-Based Nursing, Surgery, Lower Extremity Varicose Veins","lastPublishedDoi":"10.21203/rs.3.rs-6459287/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6459287/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study evaluated clinical efficacy of evidence-based nursing (EBN) care in the management of LEVV after surgery. A prospective non-randomized controlled trial enrolled 60 CEAP C2-C4 patients (2024), allocated to EBN (n\u0026thinsp;=\u0026thinsp;30) or conventional care (n\u0026thinsp;=\u0026thinsp;30). The EBN intervention featured: JBI-based preoperative education with animated demonstrations; Hemodynamic-guided stepwise compression therapy; WeChat-delivered rehabilitation addressing ambulation hesitancy. Primary outcomes included perioperative period complications, 3-month Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ). Analyses used SPSS 26.0 with t-tests and chi-square (α\u0026thinsp;=\u0026thinsp;0.05). The EBN group demonstrated a significant reduction in subcutaneous hematomas (2 vs. 8 cases, P\u0026thinsp;=\u0026thinsp;0.038), 5-fold lower limb edema incidence (1 vs. 6 cases, P\u0026thinsp;=\u0026thinsp;0.044), a superior VCSS improvement (5.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85 vs. 7.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69, P\u0026thinsp;=\u0026thinsp;0.031), a higher CIVIQ scores (79.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.54 vs. 70.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.46, P\u0026thinsp;=\u0026thinsp;0.024) and a satisfaction rate (93.3% vs. 70.0%, P\u0026thinsp;=\u0026thinsp;0.02) as compared to Control group. This study substantiates that evidence-based nursing transcends conventional perioperative care by systematically addressing biomechanical and behavioral of LEVV recovery.\u003c/p\u003e","manuscriptTitle":"The Clinical Efficacy of Evidence-Based Nursing in Surgery for Lower Extremity Varicose Veins","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-01 10:04:42","doi":"10.21203/rs.3.rs-6459287/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe2a9654-d899-4f9b-8f51-5368c3e08d60","owner":[],"postedDate":"September 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":53719706,"name":"Health sciences/Health care/Quality of life"},{"id":53719707,"name":"Health sciences/Diseases/Cardiovascular diseases/Vascular diseases/Peripheral vascular disease"}],"tags":[],"updatedAt":"2025-11-21T15:08:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-01 10:04:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6459287","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6459287","identity":"rs-6459287","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}