Surgical correction of venous incompetence restores normal skin blood flow and abolishes skin hypoxia during exercise.

Posture has long been recognized to be a crucial factor in the etiology of venous leg ulcers. Activation of the stretch receptors in the veins by venous distention induces reflex vasoconstriction and hypoxia. In patients with defective venous return, exercise fails to reduce venous pressure when the legs are dependent; therefore, hypoxia persists during exercise. Surgical treatment of venous incompetence abolishes the abnormal venous reflux and restores the normal vasodilator response to exercise, thereby correcting the sustained hypoxia observed in patients with venous leg ulcers.