Sclerotherapy: a personal appraisal.
Sclerotherapy is still an excellent procedure for treatment of sunburst venous blemishes. The technique is basic, as described previously. Points to remember are: 1. Use a syringe suited to the size of your hand. The disposable 3-cc syringe fits most hands, and does not require a reload after injection of 1 cc of sclerosant. The TBC syringe may be too long, and holds only 1 cc of sclerosant. 2. Be sure your needle is sharp. Change your needle as often as needed. It is surprising what a difference this can make. 3. Magnify your work! 4. Once you are in the vein, keep your eye on target (the needle point). A fractional deviation can cause you to perforate the tiny blood vessel. 5. Don't aim your needle under the vein; go parallel to it. 6. Inject a small bolus of air before the sclerosant solution. This ensures that you are in the venule and reduces chances of local side effects. Therefore, the syringe and needle must be tilted up, or else the bolus of air is behind the solution. 7. Remember to always store your hypertonic saline separately from all other injectables.