Presentation
The condition can appear red or hot or edematous, but venous stasis dermatitis almost always presents bilaterally. Usually the left leg is more edematous, compared with the right leg. [mdedge.com]
The present study is the first to investigate the muscle pump effect in exercise hyperaemia in patients with venous insufficiency, who should be lacking an optimally functioning muscle pump. [ncbi.nlm.nih.gov]
The following conditions* are presented: Venous Ulcers, Cellulitis, Stasis Dermatitis, Varicose Veins, Hemosiderin Staining, Vasculitis, Lipodermatosclerosis, Calciphylaxis, Pyoderma Grangrenosum, Healed Foot Ulcer, Fungal Thickened Toenails, Maceration [vatainc.com]
However, patients presenting with other symptoms of venous insufficiency, such as those listed below, should also undergo an in-depth evaluation, including a duplex ultrasound study. [advancedvenoussolutions.com]
Treatment
Symptoms and signs of CVI The problems associated with CVI do not disappear without treatment and the complexity of treatment increases as the disease progresses. [lymphedemablog.com]
Secondly, treatments will focus on the original cause of the CVI. These treatments are broken into two categories. First are the non-surgical treatments. [lymphedemapeople.com]
Venography, though often diagnostic, is invasive and often used only if treatment is being planned. Treatment for chronic venous insufficiency Treatment for venous insufficiency depends on the cause and extent of the condition. [angiologist.com]
Some of the basic treatment strategies include: Avoiding long periods of standing or sitting. [rciowa.com]
[…] be considered for treatment”. [cvtc.net]
Prognosis
Prognosis The prognosis is variable and depends on the progression of disease, extent of damage, and the presence of other diseases, which may affect the cardiovascular system. [medical-dictionary.thefreedictionary.com]
Outlook (Prognosis) Chronic venous insufficiency tends to get worse over time. However, it can be managed if treatment is started in the early stages. [baptistjax.com]
Etiology
Classification C- clinical manifestation E- etiologic factors A- anatomic distribution P- pathophysiologic dysfunction Severity Scoring 1. Number of anatomic segments affected 2. Grading of signs and symptoms 3. [jobst.com]
Bottom line: You need to consider the etiology. That's where my statement "it's not an ulcer with a varicose vein, it's a varicose vein with an ulcer" comes into play. [aapc.com]
We must identify the underlying etiology in order to help with the treatment protocol. Stay tuned for my next blog post on treatment options for patient with venous insufficiency. References 1. Callam MJ. Epidemiology of varicose veins. [podiatrytoday.com]
Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. [aafp.org]
Figure 1: Venous ulcer with obesity as cofactor Figure 2: Large superficial venous ulcer Etiology Any condition that causes blood to pool in the veins of the leg is a potential cause of venous ulcers, including varicose veins, deep vein thrombosis, or [woundsource.com]
Epidemiology
Epidemiology of Chronic Peripheral Venous Disease. In J.J. Bergan & N. Bunke-Paquette (Eds.), The Vein Book (pp. 27-36). New York, NY: Oxford University Press. 2. American Heart Association, SIR, Brand et al. [medtronicendovenous.com]
Epidemiology of varicose veins. Br J Surg. 1994; 81(2):167–73. 2. Fowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology. 2001; 52(Suppl1):S5–15. 3. Krajcar J, Radakovic B, Stefanic L. [podiatrytoday.com]
Contraceptive medication use, hypertension, previous leg injuries, and low intake of cellulose fibbers have also been considered. [5] Epidemiology United States statistics CVI is a significant public health problem in the United States. [emedicine.medscape.com]
Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Int J Dermatol. 2005;44(6):449–456. 4. Callam MJ, Harper DR, Dale JJ, Ruckley CV. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed). 1987;294(6584):1389–1391. 5. [aafp.org]
Pathophysiology
Pathophysiology of chronic venous disease. UpToDate. Last updated April 12, 2012. www.uptodate.com/contents/pathophysiology-of-chronic-venous-disease?source=search_result&search=Pathophysiology+of+chronic+venous+disease &selectedTitle=1%7E127. [woundcareadvisor.com]
PATHOPHYSIOLOGIC CLASSIFICATION Basic CEAP: Pr: reflux. Po: obstruction. Pr,o: reflux and obstruction. Pn: no venous pathophysiology identifiable. [jobst.com]
Pathophysiology of venous insufficiency during pregnancy. Acta Med Croatica. 1998; 52(1):65–69. [podiatrytoday.com]
B 32 Pathophysiology The pathophysiology of venous ulcers is not entirely clear. Venous incompetence and associated venous hypertension are thought to be the primary mechanisms for ulcer formation. [aafp.org]
Filaria Journal -------------------------------------------------------- The aetiology and pathophysiology of chronic venous insufficiency and leg ulcers http://www.ucl.ac.uk/~rehk999/cvi1.htm -------------------------------------------------------- Pathophysiology [lymphedemapeople.com]
Prevention
There are special valves in veins designed to prevent back-flow. Venous insufficiency prevents successful transportation of blood back to the heart due to impaired valves or other obstruction preventing proper vein function. [veinsofhouston.com]
[…] your weight is one way to prevent varicose veins. [coastalvascularcenter.com]
There is less pressure to pump the blood up the veins to the heart and to prevent the blood from flowing back in the wrong direction. Numerous one-way valves in the veins prevent the backflow. [healthbeat.crozerkeystone.org]
The goals of treatment are to reduce the pooling of blood and prevent ulcers. [cleaverderm.com]
Again, the key to prevention of the late sequelae of DVT and thrombophlebitis, called chronic venous insufficiency, is wearing supportive hose. [footsmart.com]