Most chronic VLUs are the end result of one thing: sustained venous hypertension.
Here’s the cascade: Valve failure → reflux (backflow) → high venous pressure while standing/walking → edema + inflammation → skin breakdown → VLU
Where the SFJ/Saphenofemoral valve matters
The SFJ is a frequent source of superficial reflux—and when it’s incompetent, it can continuously “feed” pressure into the superficial system and the ulcer zone.
But it’s not always the only driver: perforators, deep reflux, and outflow obstruction can also be fueling the hypertension.
Question to Vascular Surgeons of our Group
In your VLU patients, how often are you documenting a full duplex map of:
SFJ/GSV (source reflux)
perforators (pathway)
deep system (contributor)
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