Chronic venous insufficiency (CVI) is a common condition. The symptoms most frequently experienced with CVI are pain and heaviness in the affected limb. The pain is described as an aching throughout the limb. The condition is usually caused by a deep thrombophlebitis (blood clot) that damages the valves in the veins. This results in venous hypertension, ultimately causing edema (swelling) and other complications. The signs of chronic venous disease are grouped into three stages that dictate the degree and intensity of care.
The stages are characterized as follows:
STAGE 1 - Edema and pigmentation
STAGE 2 - Edema, skin pigmentation, and dermatitis
- STAGE 3 - Varicosities, edema, skin pigmentation, dermatitis, and ulceration
Venous insufficiency is often accompanied by edema and by decreased oxygen and nutrient content in the affected tissue. Venous insufficiency benefits from external compression, and the use of pneumatic compression devices to treat venous insufficiency has proven highly successful. Pumping promotes cutaneous circulation that increase the oxygen content of tissues.
Treatment of chronic venous insufficiency
Patients in stage one:
Use gradient elastic stockings and educate on proper skin care
Patients in stage two:
Use gradient elastic stockings, educate on proper skin care, prescribe topical steroids for dermatitis, and encourage surgical consult
Patients in stage three:
Use gradient elastic stockings and develop ulcer care protocol that includes (a) antiseptic solution (b) bio-occlusive dressings.
Effective adjunctive therapy for all three stages includes pneumatic, gradient compression therapy.