Images of Note: Volume-Based Expertise in Complex Venous Wound Care

Snapshots from the nation’s busiest noninvasive vascular laboratory

Cleveland Clinic is home to the largest and busiest noninvasive vascular laboratory in the U.S., with more than 2,220 clinical vascular imaging studies performed monthly.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

These studies include duplex venous ultrasonography for assessing lower extremity venous obstruction, venous insufficiency, varicose veins or venous valvular reflux disease, all of which can lead to delayed venous wound healing (Figure 1).

Figure 1. (Top) A representative short-axis grayscale ultrasound image showing venous insufficiency of the great saphenous vein (white arrow). Note the dilated vein, which is considered a varicose vein. (Bottom) Example of a longitudinal grayscale image (orange arrow) of the same varicose vein showing valvular incompetency as a function of reversal of venous flow (blue star). This phenomenon often leads to nonhealing leg venous ulcers.

Besides serial debridement and wound bed preparation, our vascular medicine physicians use various wound dressing materials to absorb wound drainage and mobilize cellular matrix to promote wound healing (Figure 2). Additionally, multilayer compression garments are commonly used for patients with venous wounds to reduce leg swelling and venous hypertension.


Figure 2. Section of Vascular Medicine staff physician Geoffrey Ouma, DO, tends to a patient’s lower extremity venous wound.

Cleveland Clinic’s vascular medicine specialists also collaborate with their vascular interventionalist colleagues to help restore arterial flow to the leg in cases of arterial obstruction and to employ endovenous laser ablation to treat varicose veins associated with venous leg wounds.

Related Articles

23-HVI-4400491 CQD 650×450
Low-Dose Aspirin Slows Abdominal Aortic Aneurysm Progression

Large cohort study finds significant effect in men and nonsmokers

completed mitral valve repair
Mitral Valve Re-Repair for Degenerative Disease Found Safe and Durable

Cleveland Clinic series supports re-repair as a favored option regardless of failure timing

troubled-looking man in his thirties or forties
Infective Endocarditis Due to Opioid Addiction: Two Diseases, Highly Divergent Outcomes

Cleveland Clinic study points to need for new strategies to curb addiction relapse

older woman using computer
Web App Enables Safe, Effective Nonprescription Statin Use

Tech-assisted self-selection concurred with clinician-assessed eligibility in >90% of cases

atherosclerosis in coronary artery
Untreated Obstructive Coronary Artery Disease Safe in TAVR Recipients, Study Shows

Support for a TAVR-first approach in patients with concurrent valve and coronary disease

tumor in an upper chamber of the heart
Excellent Outcomes Achievable With Surgical Resection of Benign Cardiac Tumors

Recurrences were rare and survival robust in large Cleveland Clinic study