Treatment of circulatory disorders of the lower extremities

Successful treatment of the cutaneous changes in patients with arterial insufficiency and venous insufficiency is enhanced by a knowledge of (1) the physiology of the blood vessels in health and in disease (2) the pathologic changes underlying these disorders and (3) the side reactions of drugs as well as their efficacy. Treatment of stasis dermatitis often requires elevation of the involved leg at hourly intervals during the days, especially in patients who must continue to work and who must stand for long periods. In patients with stasis dermatitis, above-the-knee elastic stockings can produce a tourniquet effect in the popliteal space and can be hazardous. When the cutaneous changes do not heal properly, the physician must be alert to factors which, although seemingly minor, may mean the difference between a successful short course of treatment and chronicity.