The old understanding of how venous leg ulcers occurred

Up until the 1980's most doctors and nurses had a clear (but incorrect) understanding about what valve failure in each of these systems meant.

It was thought that failure of the DEEP valves (picture on the left) caused inflammation in the deep tissues that eventually caused ulcers (pictured LEFT) - but failure of the SUPERFICIAL valves only led to stretching of the vein walls and VARICOSE VEINS (pictured RIGHT).

At this time varicose veins were thought to be cosmetic only and leaving them did not matter.

THIS RESULTED IN INCORRECT ADVICE GIVEN TO PATIENTS UP UNTIL THE 1980's:

THE OLD AND INCORRECT ADVICE:
1] IF YOU HAVE ULCERS - this was thought to be due to DEEP vein reflux - and as this cannot be cured surgically, the patient was advised to have regular dressings and tight bandages to reduce the back flow of blood falling down the deep veins.

2] IF YOU HAVE VARICOSE VEINS - these were thought to be cosmetic only, and were thought to always come back even if treated. Patients were therefore told they could have them removed by surgeons - but there was little point in doing so unless they were painful or causing a problem.

HOWEVER - in the 1980's a new test called Duplex Ultrasound showed us that this simplistic way of thinking about veins was WRONG.