UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: Vein Ligation
Effective Date: February, 2005 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed March 2008 May 2009 November 2011
PURPOSE: To provide guidelines for setting up and assisting with vein ligation at UWMF clinics.
DEFINITION: The procedure of tying off a blood vessel with a suture or wire ligature. It may be performed
to treat varicosities and/or stop spontaneous or traumatic hemorrhage.
POLICY: The clinical staff will utilize the following guidelines to assist with a vein ligation.
SUPPLIES: Provider’s order, Patient’s record, Permit for Operation, Sterile surgical tray, 10 cc syringe,
Sutures (provider preference), Local anesthetic, 18 G needle, 25 G needle, Vicryl Ties
Betadine or Chloroprep (provider preference), 2 set sterile gloves and gowns, Chux pad,
Cloth drape or gown
1. Check provider’s order and clarify any inconsistencies.
2. Wash hands and gather equipment.
3. Introduce yourself and identify the patient. Include date of birth. Verify allergies (specifically to betadine,
chloraprep and local anesthetic)
4. Using sterile technique open surgical tray, and place any additional instruments needed into tray. Re-cover
tray until needed.
5. Provide good light and provide privacy by closing curtains and door.
6. Room patient – Refer to Provider Preference List for Rooming Patients.
7. Explain procedure to the patient.
8. Following the provider’s discussion with patient, have patient sign Permit for Operation and sign form as a
9. Instruct patient to remove lower clothing and cover with drape.
10. Assist patient into comfortable position on the table.
11. Wash hands, and apply sterile or clean gloves as requested by provider.
12. Cleanse area with betadine or chloraprep.
NOTE: Use alcohol if allergic to betadine or chloraprep.
13. Remove gloves and wash hands.
14. Assist patient to comfortable position and assist with dressing (if needed)
Give patient “Post-op care of the Incision” handout.
Review handout with patient, filling in blanks.
Assist patient to waiting room and with follow-up appointments (if needed).
15. Apply gloves and clean all surfaces with Dispatch
Bring surgical tray and instruments to dirty utility room
Place needles in sharps containers
Discard waste and disposable equipment in proper receptacles
Wash instruments and tray in dirty utility room
Remove gloves and wash hands
Bring instruments to clean utility room
16. Wrap surgical tray and instruments for sterilization.
17. Documentation (in Progress Notes section of HealthLink) in the patient’s record:
the procedure performed, date & time completed
how the patient tolerate the procedure
name and amount of any medications given (using SmartPhrase: .medinclinic)
discharge instructions and follow-up appointment (if any)
WRITTEN BY: Beverly Polzin, R.N., Department of General Surgery
REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
REVIEWED BY: Kelly Meyer R.N., Department of General Surgery
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams &
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Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St.
Louis, MO: Mosby Elsevier.
Department of Surgery Date
Medical Director Date