Registered Nurse (RN)
Medical Surgical Nursing & Pathophysiology
Vascular Disorders
Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment

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Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment

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Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment

Crone bound by Vines with Assess-man
Chronic venous insufficiency is a condition that occurs when leg veins and valves fail to maintain blood movement. This can lead to the development of venous stasis ulcers, which are painful and debilitating. With this disorder, patients can have lower leg edema, bronze-brown skin pigmentation and pruritus. Ulcerations are necrotic with uneven edges, and typically occur in the medial malleolus, presenting with dull persistent pain. It is important to note that because arterial flow is not compromised, the patient’s lower extremities are warm and still have palpable pulses.
Venous Stasis Ulcer
Vines on Stop-sign at Ulcer-volcano

Due to decreased venous blood movement, patients develop venous stasis ulcers. These are not life-threatening, but are debilitating and painful, drastically decreasing the patient’s quality of life.

Uneven Edges
Uneven Edges

Ulcers with this disorder form over time, with edges that have thick, hardened, and contracted skin. Characteristically, venous ulcers have uneven edges.

Dull Persistent Pain
Dull-guy with Persistent Pain-bolt

The venous stasis ulcers seen in patients with chronic venous insufficiency present with dull persistent pain. These are especially painful when the ulcer is on the foot and edema or infection is present, or if the foot is in a dependent position. Thus, elevating the legs can alleviate pain.

Medial Malleolus
Metal Ankle-bones

Clinically, venous stasis ulcers are seen around the medial malleolus, and patients have skin and subcutaneous tissue changes in these areas. The ankle tissues are replaced with fibrous tissue, giving a thick and hardened appearance.


Patients with chronic venous insufficiency can have ulcers which are necrotic and nonhealing. If these wounds persist and increase in severity, with the wound becoming bigger and deeper, amputation may be needed.

Normal Pulses
Normal Pulsing heart

As arterial flow is still maintained in chronic venous insufficiency, patients have normal pulses. However, these may be difficult to palpate, if edema is present in the patient.

Lower Leg Edema
Lower Leg Edamame

Due to decreased venous flow, patients develop lower extremity edema. The presence of edema can exacerbate the pain in patients with venous stasis ulcers.

Bronze-Brown Pigmentation
Bronze-Brown Pig-man

In chronic venous insufficiency, individuals can have leathery lower legs that have a bronze-brown pigmentation. This occurs due to hemosiderin deposition and is typically seen around the ankles.

Warming heat

Though venous flow is compromised, arterial flow is not. Thus, patients have warm lower extremities, and even the areas of skin affected by ulceration are warm to the touch.


“Stasis dermatitis” is a condition that may develop with venous insufficiency, which resembles eczema. A common complaint is itching, or pruritus, with the development of this condition.


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