Anatomy, physiology and venous ulceration

Area of Science:

• Vascular Medicine
• Dermatology
• Phlebology

Background:

• Historically, deep venous system diseases like deep vein thrombosis were considered primary causes of venous ulceration.
• Emerging evidence highlights the significant role of venous valvular incompetence and reflux in both deep and superficial systems.
• The understanding of venous ulceration etiology is evolving to include superficial venous pathologies.

Purpose of the Study:

• To review the current understanding of venous ulceration causes.
• To emphasize the impact of superficial venous disease on ulceration.
• To discuss the mechanisms linking venous disease to skin damage.

Main Methods:

• Literature review of studies on venous ulceration and venous disease.
• Analysis of etiological factors in venous ulcer development.
• Synthesis of current clinical and scientific understanding.

Main Results:

• Superficial venous valvular incompetence and reflux are significant contributors to venous ulceration.
• Superficial venous disease can independently cause increased venous pressure at the ankle.
• This elevated pressure leads to skin damage and the formation of venous ulcers.

Conclusions:

• Venous ulceration is multifactorial, with both deep and superficial venous systems playing crucial roles.
• Superficial venous disease is now recognized as a direct cause of venous ulceration.
• Addressing superficial venous insufficiency is vital for managing and healing venous ulcers.