How should you manage chronic venous insufficiency?

Treatment is directed primarily toward reducing venous pressure. This end can be achieved with elevation of the legs, active exercise, supportive stockings, sclerotherapy of selected perforator veins, or surgical treatment. Surgical options are dependent on the site involved but include ligation and stripping of the saphenous vein, ligation of incompetent perforators, or valve replacement. Dermatitis (stasis dermatitis), if present, may be treated with mild to moderate corticosteroids, and oral antibiotics may be used if secondary infection is present. Venous ulcers are treated with these options but also require wound management.

Sieggreen MY, Kline RA: Recognizing and managing venous leg ulcers, Adv Skin Wound Care 17:302–311, 2004.