Editing Edema (section)

=== Veins ===
Phlebetic lymphedema (or phlebolymphedema) is seen in untreated [[chronic venous insufficiency]] and is the most common type of edema (approx. 90%).<ref name=":1">{{Cite web |last1=Publishing |first1=Licorn |last2=Guiboles |date=2009-11-24 |title=The causes of edema in chronic venous insufficiency |url=https://www.phlebolymphology.org/the-causes-of-edema-in-chronic-venous/ |access-date=2023-09-01 |website=Servier - Phlebolymphology |language=en-US}}</ref> It is a combination venous/lymphatic disorder that originates in defective "leaky" veins that allows the blood to back flow ([[Chronic venous insufficiency|venous reflux]]), slowing the return of the blood to the heart ([[venous stasis]]). The venous pressure in the legs changes dramatically while standing compared to lying down. How much pressure there is depends on the person's height, in the average adult person, it is 8 mm Hg while lying down and 100 mm Hg while standing.<ref name=":2">{{Cite journal |last=Farrow |first=Wade |date=2010 |title=Phlebolymphedema-a common underdiagnosed and undertreated problem in the wound care clinic |journal=The Journal of the American College of Certified Wound Specialists |volume=2 |issue=1 |pages=14–23 |doi=10.1016/j.jcws.2010.04.004 |issn=1876-4983 |pmc=3601853 |pmid=24527138}}</ref>

In venous insufficiency, venous stasis results in abnormally high venous pressure (venous hypertension) and greater permeability of blood capillaries (capillary hyperpermeability), to drain the blood through the lymphatic system. The lymphatic system slowly removes excess fluid and proteins from the veins in the lower legs towards the upper body; however, as it is not as efficient as an unimpaired circulatory system, swelling (edema) is visible, particularly in the ankles and lower leg. The chronic increased fluid in the lymphatic system and capillary hyperpermeability causes an inflammatory response which leads to tissue fibrosis of both veins and lymphatic system, opening of arteriovenous shunts, all of which then worsens the condition in a vicious cycle.<ref name=":1" /><ref name=":2" />