Skin flow and swelling in post-phlebitic limbs

It has been demonstrated that skin blood flow of postphlebitic limbs is increased. Also the venoarteriolar response (VAR), i.e. precapillary vasoconstriction present in normal limbs on standing up, is reduced in limbs with venous insufficiency, resulting in capillary hypertension. The supine skin resting flow (SF) and the skin flow on standing (SF) have been measured with laser-Doppler in 30 normal lower limbs and 70 postphlebitic limbs with ambulatory venous pressure greater than 65 mmHg; also, the rate of ankle swelling (RAS) has been measured with strain-gauge plethysmography. The VAR was derived from VAR = 100* (RF-SF)/RF. The reduction of VAR and the increase in SF, which has been demonstrated in the postphlebitic limbs, correlated well with the rate of ankle swelling (RAS). The measurements of SF, VAR and RAS evaluate objectively the degree of impairment of the microcirculation because of severe venous disease. They offer the possibility to study the natural history and the effect of treatment of venous hypertensive microangiopathy.