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Venous diseases

There is no need for compression bandaging on a healthy leg

One of the main tasks to be performed by the venous system in the leg is the return transport of the blood to the heart. This requires the presence of various physiological driving forces and mechanisms, such as e.g. the muscle pump of the calf and the foot sole. Almost all veins have so-called venous valves, which make sure that the blood flows only in one direction. During movement of the legs, the deep veins are compressed with every muscular contraction: this forces the blood out towards the heart and the venous valves prevent the blood from pooling back into the veins.

Similar mechanisms in the joints during movement causing the veins to expand and relax also promote the return transport of the blood.

Schematic diagram of the veins (cross-section) with venous valves

The deep veins transport the blood back to the heart and, in doing so, overcome the force of gravity. The most effective factors in this process are the functional unit of the calf muscle pump and the venous valves. With every muscular contraction (so-called muscular systole) the deep veins are compressed. This forces the blood out proximally towards the heart and the distal venous valves prevent the blood from pooling back into the veins.

When the muscles relax (so-called muscular diastole), the proximally located venous valves prevent the blood from pooling back into the veins. In the deep veins a negative pressure develops which results in blood being aspirated through the perforating veins from the more distally located superficial venous system.

If, the calf muscle pump effects of the veins are disturbed and the valves do not close properly, this leads to volume-overload with dilatation of the veins, which results in local blood flow disturbances in the subcutis or cutis. Finally, a sequences of processes leads to the development of venous leg ulceration.