1 - The venous system of the lower limb
2 - Pressure in the venous circulation at rest
3 - Functional anatomy relating to the venous system of the
legs
4 - The venous pump of the lower limb
5 - Valve failure and venous reflux (venous insufficiency)
6 - `Venous hypertension’ - an obsolete term
7 - Inflammation in venous reflux disease (chronic venous
insufficiency)
8 - Pressure, flow and inflammation - how they relate in venous
reflux disease
9 - Varicose veins - the `good guys’
10 - Patterns of reflux - passive and active phase reflux
11 - Conclusion
This book has been written for two groups of people.
The first is for healthcare professionals who either are treating
people with venous problems or who wish to do so.
The second is for members of the general public who want to
understand more about the cause of varicose veins, thread veins of
the legs and other venous conditions such as venous leg ulcers.
After all, these conditions will affect almost half the population
at some stage in their lives and currently is treated by a variety
of people in a variety of ways - with very different outcomes. In
order to make sure they or their loved ones get the best treatment,
a good basic understanding of the problem by the healthcare
professional is essential - and the ability to ask informed
questions can often help to make sensible choices as to treatment
options.
Although one would expect qualified people to have a very thorough
understanding of their subject, research in varicose veins and
venous reflux disease (or venous incompetence) has progressed at a
rapid rate over the last decade or so. This, coupled with the
unfortunate and incorrect view of a great many people both inside
and outside healthcare that varicose veins are "only cosmetic", has
meant that there is very little pressure on the majority of people
who treat veins to keep up with the research and our new
understanding of venous physiology.
Since 1999, I have been running courses to teach healthcare
professionals how to treat varicose veins, thread veins and other
venous conditions such as venous eczema and leg ulcers. During that
time, it has amazed me that none of the professionals coming on my
courses - whether surgeons, other doctors, nurses, beauty
therapists or dentists - have been able to answer all of the simple
questions that I pose about how veins work and the consequences of
the valves failing in different veins. Although they all know that
the basic problem is that the "valves aren't working", the problems
that result from this and how it affects the legs seem something of
a mystery to them. As understanding this is essential to good
venous treatment, this is clearly very worrying.
I have written this book in a very simple style, that should be
very easy to follow, much in the way that I teach on my courses. My
understanding of varicose veins and venous reflux disorders has
been amalgamated from my own research and experience, coupled with
a large number of other influences learned from reading research
papers and listening to research presentations from other research
units. I have not attempted to reference any of these, as to try
and find all of the influences that have contributed to my
understanding of this subject over the last 20 years would be
impossible.
I hope that this resulting book will take the reader through this
fascinating subject and give them a deeper understanding of this
very common problem. If by doing so this book helps healthcare
professionals to understand their subject deeper and therefore
review their treatment strategies, and helps members of the general
public to understand what might be going on in their own legs or
the legs of their friends and relatives in order that they may ask
relevant questions of proposed treatments, then it has served its
purpose.
Mark Whiteley is a consultant venous surgeon and founder of The
Whiteley Clinic, now in London, Guildford and Bristol. He is also a
visiting Professor at the University of Surrey and an
internationally recognised expert in venous disease and endovenous
surgery.
Mark qualified in 1986 from St. Bartholomew's Hospital, completed
the Bristol and Portsmouth surgical rotations before becoming a
lecturer in surgery at the University of Bath followed by Oxford
University. He was appointed as a consultant vascular surgeon at
The Royal Surrey County Hospital before leaving and becoming 100%
venous surgeon in 2005.
With his colleague Judy Holdstock, he introduced endovenous surgery
into the UK by performing the first endovenous operation in the
country on 12th March 1999. Mark founded The Whiteley Clinic in
2001 and invented the TRLOP operation with Judy Holdstock the same
year.
He founded The College of Phlebology in 2011 and runs an annual
international veins meeting in London, and founded the Leg Ulcer
Charity - to empower patients to find a cure and to teach health
care professionals that most leg ulcers can be cured without long
tern dressings and bandages.
Mark has written this book and edited another book on veins; has
written 15 chapters on veins in textbooks; has over 110
peer-reviewed research papers and has won multiple international
and national prizes for his work in veins. He is regularly invited
to meetings around the world to give guest lectures on venous
diagnosis and treatments, or to chair or moderate sessions and sits
on the international committee of the American Venous Forum. In
2017 he was given an award by Publons for being in top 1% of
medical reviewers as a peer-reviewer for venous papers.
Committed to education, Mark runs the EVLT (endovenous laser
treatment) International Academy for Angiodynamics 4 times per year
since 2012 and runs courses, work experience, summer research
fellows, extended research fellowships and PhD students.
He won a KTP grant from the UK government to set up a research
department - performing confidential research for companies to
advise them on how to optimise their vein treatments and to do his
own research to ensure the efficacy of treatments used at The
Whiteley Clinic as part of The Whiteley Protocol.
Mark is regularly featured in the national media in the UK: he has
been recommended by Tatler for the last 10 years. He has had
multiple appearances on TV including - "Embarrassing Bodies",
"Harley Street", "Don't ask the Doctor" as well as being featured
in featured in national newspapers and magazines regularly.
Muhammad Salim; 5.0 out of 5 stars: Simple and well written. The book is easy to read. Concepts are explained in a simple yet concise way. I recommend this book to anyone who needs a good start in understanding venous reflux Disease. Kenneth U. Ekechukwu. 5.0 out of 5 stars: Superb new text on the block. Excellent, concise, and easy to read. Bold and truthful in debunking misleading, confusing time-honoured traditions and concepts. A firm foundation for understanding the basics of venous disease of the loer limbs and a reliable intro of the problem for the beginner and the dogmatic old horse. May benefit from some grammatical editing to remove distracting errors. IDMansell. 5.0 out of 5 stars: Understanding venous reflux: I'm a Tissue VViabilitynurse and was recommended this book by a vascular consultant at a conference in Manchester. I've been teaching district nurses and care home staff how to assess & manage venous leg ulcers for over 15 years. Part of the course includes pathophysiology of venous disease being a great believer in treat the cause not the symptom. That's been blown out of the water by the revelations in this book. It's easy and concise to read with good systematic approach to understanding venous reflux. "venous hypertension" becoming an obsolete term is initially difficult to assimilate, but the clarity of the text and research appears irrefutable. Although judging from the book there are still those out there who prefer to do just that. Chapeter 7 & 8 are the clinchers and worthy of careful analysis . The preceding chapters lead you in with simple explanation of the venous system and how it functions. Good use of simple diagrams support and consolidate the text. Some of the myths associated with venous hypertension are also refuted. Male vs female incidence obesity & pregnancy are disputed as well as other established so-called facts precipitating venous disease. I would recommend this book as does the author if you're any way involved in dealing with patients with venous ulcers both to correctly inform your patients and support staff in the assessment and management of venous leg ulcers. "once a leg ulcer patient always a leg ulcer patient" but not it would appear with venous hypertension but with venous reflux.
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