Normal Circulation

• A working circulation enables blood to flow from the heart in the arteries to supply oxygen and nutrients to the organs of the body.
• To cope with the high pressure generated by the heart, the arteries are muscular.
• Thinner-walled veins carry the blood from the organs back to the heart.
• Returning blood passes in the veins through the abdomen to replenish the nutrients and dispose of waste products through the organs, such as the kidneys, bowel loops and liver.
• Blood then passes in the veins through the lungs in the chest to enable the oxygen levels to increase.
• To assist with the return of the blood to the heart, the veins are more numerous and contain one-way opening pockets, called valves.
• Valves control the direction of the blood flow, directing it toward the heart and often against gravity.

Refluxing Veins

• When the valves of the veins become dysfunctional in the condition of venous insufficiency, the direction of blood flow can go both ways, allowing backward or refluxing movement.
• Refluxing valves result in blood pooling in the veins and impaired blood return to the heart. 
• A common risk factor for the failure of the valves in the veins is a positive family history.
• Other events, including prolonged excessive standing, habitual heavy lifting, and previous blood clots in the veins, may explain the cases with one lower limb involvement. 
• These incompetent valves can occur in the superficial veins in the subcutaneous tissues or in the deep veins amongst the muscles. 

Chronic venous insufficiency of the superficial veins

• Our business deals with the refluxing superficial veins or venous insufficiency in the lower limbs.
• When the superficial venous disease progresses over time to cause the veins to bulge, they are called varicose veins.
• Although many are typically visibly bumpy or rope-like, some of these varicose veins are not visible at the skin and lie hidden deeper in the subcutaneous tissues.
• Eventually, the increased pressure in these veins extend to affect the adjacent venous tributaries. 

Consequences of chronic venous insufficiency

• The pooling of the blood in the refluxing superficial veins usually incites an attempt at healing with an inflammatory process that becomes longstanding or chronic.
• The process results in symptoms and poor skin health.
• The development of the symptoms are variable.
• There are people with visible varicose veins who do not yet have symptoms, while others without visible disease have troublesome symptoms. 
• This means that physical examination has a limited role.
• The most effective and accurate way to understand the amount of refluxing superficial veins is to perform an ultrasound to map the extent of the disease.

 SYMPTOMS

• Superficial refluxing veins can cause symptoms of aching, throbbing, and heaviness, usually worse at the end of the day.
• These superficial veins can develop clots, which may be painful.

SKIN COMPROMISE

• Chronic refluxing venous disease can compromise the health of the skin, leading to itchiness, brown skin discolouration and varicose eczema.
• In severe cases, the skin can break down, causing ulcers, which may not heal due to the underlying poor skin health.