November 2005, Volume 35 Number 11 , p 70 - 70
GALVAN, LINDA RN, APN, CWOCN, BSN
ABOUT 1 MILLION Americans have a leg ulcer caused by venous insufficiency. A patient may wrongly assume that once the ulcer heals, the problem goes away—in fact because venous disease is lifelong, she'll need lifelong therapy. In this article, I'll describe venous insufficiency and how to assess venous ulcers. In my next article, I'll explain how to use compression therapy to manage a venous ulcer.
When vein valves fail
Normally, the pumping action of calf muscles helps push blood from the legs back up to the heart; vein valves prevent blood backflow. Venous insufficiency occurs when vein valves fail in superficial or deep veins, or both. Blood backs into the leg veins, resulting in venous hypertension and superficial vein distension. Damaged vein walls let fluid exude into the interstitial spaces, causing edema. Eventually, red blood cells also leak into the interstitial spaces, breaking down and depositing hemosiderin in ...