View source for Venous stasis

==Background==
*Decreased rate of return of venous blood flow to heart (most commonly in lower extremities)
*Leads to characteristic vascular and skin changes
*Common in individuals with chronic vascular disease, diabetes, obesity, smoking history, prolonged immobility

==Clinical Features==
[[File:Chronicvenousinsufficiency.jpg|thumb|Long term venous stasis skin changes]]
[[File:PMC3152448 mjhid-3-1-e2011026f2.png|thumb|Chronic venous stasis ulcer.]]
===Venous stasis dermatitis===
*Skin becomes darker/purple, dry, tight, and hairless
**In severe cases may see venous insufficiency ulcers
*Patients may complain of leg heaviness, fatigue, or cramping
*Unlike [[cellulitis]], erythema from venous stasis tends to change with dependent positioning of the affected limb

==Differential Diagnosis==
*[[Cellulitis]]
*[[Deep venous thrombosis]]
*[[Acute arterial ischemia|Critical limb ischemia]]
*[[Peripheral artery disease]]
*[[Popliteal (Baker) Cyst|Ruptured Baker cyst]]
*[[Superficial thrombophlebitis]]
*[[Necrotizing fasciitis]]
*[[Compartment syndrome]]
*[[Complex regional pain syndrome]]

==Evaluation==
*Duplex scan if suspicion for DVT

==Management==
*Limb elevation, compression, and increased exercise

==Disposition==
*Discharge
*Considerations for admission to medicine or surgery for ulcers:
**Patients with significant occlusive arterial disease require specialist assessment of the severity
**For treatment of underlying medical problems such as rheumatoid arthritis, peripheral vascular disease, diabetes mellitus, etc.
**Ulcers with mixed etiologies, diabetic ulcers
**Suspected malignant ulcers
**Nonhealing ulcers (a minimum of at least 6 months of compression and local wound care followed by reassessment of venous function should be done before operative plastic surgical intervention is considered)
**Rapid deterioration of the ulcer
**Recurrent ulcers
**Reduced ABPI <0.8 or increased ABPI >1.0
**Infected foot
**Ischemic foot <ref>Dogra S, Sarangal R. Summary of recommendations for leg ulcers. Indian Dermatol Online J. 2014;5(3):400-407. doi:10.4103/2229-5178.137829</ref>

==See Also==


==External Links==


==References==
<references/>
https://www.uptodate.com/contents/overview-and-management-of-lower-extremity-chronic-venous-disease?search=venous%20stasis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H10
[[Category:Vascular]]