ABSTRACT
A further limitation of some publications in this field are the types of venous disease which were included and the definitions of venous disease that have been employed. In some studies, patients with minor varices such as telangiectases and reticular varices have been excluded from assessment. In others they have been included. Our developing understanding of venous disease has resulted in a series of changes of definition and description of venous valvular incompetence. In the earlier studies, these were based principally on clinical examination, or on photography in the case of Widmer’s study. He recognized three classes of varicose vein and that patients
with skin changes of any type reflected a more severe stage of venous disease. He referred to such patients as having ‘chronic venous insufficiency’. His classification is shown in Box 2.1.
