Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Chronic Venus Insufficiency. And you can find written notes on this topic at

0.0.com slash chronic venous insufficiency or in the vascular surgery section of the zero

de finals surgery book. So let's get straight into it. Chronic venous insufficiency occurs when

blood is not efficiently draining from the legs back to the heart. Usually this is the result

of damage to the valves inside the veins.

This damage may occur with age, immobility, obesity, prolonged standing or after a deep vein

thrombosis. It's often associated with varicous veins.

The valves inside the veins are responsible for ensuring that blood flows in one direction

as the leg muscles contract and squeeze the veins. When the valves are damaged, the pumping

effect of the leg muscles becomes less effective in draining blood towards the heart. Blood

pools in the veins of the legs, causing venous hypertension.

Chronic pooling of blood in the legs leads to skin changes.

The area between the top of the foot and the bottom of the calf muscle is the area most

affected by these changes, and this is known as the gator area.

Hemosidarin staining is a red-brown discoloration which is caused by hemoglobin leaking out of the

vessels into the skin. Hemosidarin is a breakdown product of hemoglobin.

Venus Exma or Varicusma, refers to dry, itchy, flaky, scaly, red and cracked skin.

These exma-like changes are caused by a chronic inflammatory response in the skin.

Lipodomatosclerosis refers to hardening and tightening of the skin and the tissue beneath the

skin.

Chronic inflammation causes the subcutaneous tissue to become fibrotic, turning into scar tissue.

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