Chronic venous disease. Part 1: pathophysiology and clinical features

Abstract

Chronic venous disease (CVD) is a commonly encountered condition in the dermatology outpatient department. If untreated, CVD may progress to chronic leg ulcer causing serious morbidity to the patient. It also affects the quality of life of the affected patient and contributes to loss of work productivity. The spectrum of clinical manifestations for CVD is myriad, ranging from asymptomatic varicose veins and pigmentation to ulceration and scarring. Awareness of spectrum of clinical presentations is required to identify, diagnose and manage CVD. Long-standing cases may develop ankle joint stiffness, fixed flexion deformity, periostitis and even Marjolin ulcer. Increased venous hypertension, thought to result from valve incompetence and failure of the calf muscle pump, is central to the pathophysiology of the development of CVD. Tissue oedema, hypoxia and subsequent fibrosis are major immediate contributing factors responsible for the clinical manifestations of CVD. Localized, chronic inflammation is now increasingly being recognized as a key player, directly responsible for stasis dermatitis and hypercoagulable state. The complete ramifications of persistent inflammation in CVD are yet to be understood and serious systemic morbidities such as arterial and cardiac disease are increasingly being recognized in association with CVD.

Personalized compression therapeutic textiles: digital design, development, and biomechanical evaluation

“…Chronic venous disease (CVD) in biologically lower extremity caused by the valvular incompetence of venous system has been considered as the clinical spectrum ranging from asymptomatic symptoms to venous ulceration ( Guo et al, 2019 ; Kumar et al, 2022 ). Recently, the prevalence of CVD globally increased from 7.5% to 73% varied by gender, aging, geographic area, and occupational factors ( Saliba et al, 2020 ; Aslam et al, 2022 ; Gujja et al, 2022 ; Stücker and Rabe, 2022 ).…”

Combining an Acidic Compound and NPWT: Debridement and Granulation in Leg and Foot Ulcers

“…Many typical skin ulcers such as venous leg ulcer and diabetic foot ulcers are, depending on their type, characterized and/or caused by aspects such as fibrin deposition, local oedema, hypoxia, fibrosis and microcirculatory problems and these factors also contribute to healing being stalled in a (hyper) inflammatory state [9]. The typical ulcer is covered with necrosis and a biofilm.…”