Arteries are the blood vessels that bring blood away from the heart, to the rest of the body, including the legs. Veins are the blood vessels that bring blood back to the heart. They have one-way valves that help to prevent the backflow of blood when pumping against gravity. Many factors contribute to the development of CVI and venous leg ulcers, including deep vein thrombosis, varicosities, decreased mobility, obesity, trauma, family history, or traumatic injury. These conditions can cause damage to the veins and the valves, complicating their ability to pump blood out of the veins. As a result, blood pools and causes the veins to swell.
With CVI, the veins become swollen and blood cells begin to leak out of the veins and into the skin of the legs. At this point, some of the signs and symptoms of CVI appear. An early sign is the brown or reddish-brown discoloration of the skin in the calf area. Swelling in the legs is common, and the skin on the legs may feel tough or leathery. If significant swelling is present in the legs, the skin can become red and fluid may begin to drip from the skin. Patients may describe this skin as "weepy". When CVI is present, oxygen and nutrients can have trouble reaching the skin. As a result of CVI, venous leg ulcers can form.
Compression therapy is essential to help eliminate the edema or swelling and to help the veins work more efficiently to pump the blood from the legs back to the heart. Compression therapy exists in a variety of forms, ranging from rigid compression therapy to two-layer and four-layer compression bandages, and finally, elastic compression stockings. The type of compression therapy a doctor recommends depends upon the presence and location of ulcers, the severity of ulceration, the patient’s lifestyle, available caregivers, and the patient’s overall health.
Patients can improve their venous health by elevating their feet and legs above the level of the heart for a portion of the day, and exercising. Routine exercise can help in two ways: it encourages blood flow, and promotes weight loss, both of which help to control chronic venous insufficiency. Walking is the best excercise for the legs, but when walking is not possible, simple excercises can be beneficial. These include wiggling the toes, flexing the foot back and forth, extending and flexing the leg, and standing flat-footed and rising tot he balls of the feet. Patients should repeat these excercises several times an hour to improve venous return.
The most important thing to help maintain healthy legs is to wear elastic compression stockings.
