Chronic Venous Insufficiency

Question 1

What is it?

Answer 1

Pooling of blood in distal veins causing the leakage into the extravascular space
Haemoglobin is broken down into haemodiserin which collects in the shins causing a brown discolouration
There is inflammation and drying of the skin causing venous eczema

Fibrosis and hardening of the skin results in narrowing of the lower legs- lipodermatosclerosis

Question 2

How is it managed?

Answer 2

Keep Skin healthy
Improve venous drainage
Management of complications

Question 3

How can you keep skin healthy?

Answer 3

Monitor for damage
Regular emollients for eczema
Steroids for eczema flares
Potent steroids for lipodermatosclerosis

Question 4

How can venous drainage be improved?

Answer 4

Lose weight
Exercise
Elevate legs when resting
Compression stockings- once arterial disease excluded

Question 5

How can complications be managed?

Answer 5

Analgesia for pain
Abs for infection
Ulcer care