Chronic venous insufficiency (CVI) affects many adults age 50 and above. It can cause significant health problems including pain, skin changes, and edema. It also causes chronic leg wounds known as venous stasis ulcers (VSU’s).
CVI is often caused by damage to the one-way valves in the veins in the legs. Damaged valves allow blood to flow backwards, increasing the pressure in the veins. The excessive pressure causes fluid to leak out of the vein capillaries. This fluid collects under the skin between the cells and is called edema.
Edema can cause significant leg swelling. It also slows oxygen and nutrient delivery to the tissues. This causes cell death, which turns on the body’s inflammatory response to injury. As the inflammation is chronic due to the stagnant edema, the body begins to build up collagen tissue, causing hardening (fibrosis). Other skin changes occur, including pigmentation from broken-down red blood cells (hemosiderin staining), stasis dermatitis (itchy, flaky skin), and lipodermatosclerosis (inflammation of the fatty tissue in the skin) which forms a hard, contracted band of tissue at the ankle, giving the legs an “inverted champagne bottle” appearance.
Venous insufficiency edema is a leading cause of lymphedema. Phlebolymphedema (lymphedema caused by venous insufficiency) develops when the lymphatic vessels are damaged by inflammation or by edema lymph fluid overload that strains the lymph vessel walls beyond capacity. Phlebolymphedema adds to the edema from the veins and further increases the edema and inflammation.
As chronic venous insufficiency progresses, wounds may open up in the skin of the lower leg (spontaneously or as a result of external injury). These wounds are called venous stasis ulcers. They tend to be chronic because the underlying venous insufficiency condition does not provide the healthy support needed to allow wounds to close and heal. Venous stasis ulcers can cause significant health issues. They may become infected and /or get quite large if they remain untreated.
Treatments for CVI and Venous Stasis Ulcers (Wounds)
Compression is the cornerstone of treatment for CVI and venous stasis ulcers. It works by pressing against the leg tissue, increasing the pressure outside the vein walls. This increased external pressure reduces the quantity of fluids that leak out of the vein capillaries and also boosts the veins’ ability to move blood back to the heart.
Static compression includes compression stockings and bandaging. However, patients often are not able to apply compression stockings effectively themselves. Multilayer bandaging in clinic is very effective; however, ulcers that have healed often reopen or appear in another place on the leg once a course of bandaging is discontinued.
Intermittent pneumatic compression therapy (IPC) with Lympha Press® is a highly effective method for treatment of chronic venous stasis ulcers. It is very easy to use and can be self-applied regularly by the patient without assistance.
Lympha Press® treats CVI by:
- Increasing venous blood return. This reduces the production of edema fluid and helps prevent further damage to veins.
- Increasing lymph transport. This removes edema.
- Moving edema proximally toward functional lymph vessels. This enables edema removal when the local vessels are damaged by inflammation.
Lympha Press® speeds healing of venous stasis ulcers and prevents their recurrence by:
- Increasing oxygenation to the wound bed. Increased oxygenation helps the wound to heal.
- Assisting wound closure by reducing the swelling that keeps the wound edges apart.
- Increasing venous return during the daily treatment sessions.
A treatment plan including Lympha Press® can prevent progression and heal ulcers.
Lympha Press® is easy to use at home, as part of a total care plan including static compression (such as compression stockings) and wound care.
Lympha Press PCD-51 ™ is designed to treat CVI edema. It provides accurate pressure and automatic or user-selected pause, to ensure complete deflation for vascular refill in between compression waves.
View a webinar
A webinar with James McGuire DPM PT LPed, FAPWHcDirector: Leonard Abrams Center for Advanced Wound Healing, Clinical Professor: Temple University School of Podiatric Medicine Philadelphia, PA.