Chronic Venous and Arterial Ulcers

A Drainage System With Broken Locks

Your leg veins are like a multi-story apartment building's plumbing: water (blood) flows down from the roof (heart) through pipes (arteries) to reach every apartment (skin cells), then collects in a drain system (veins) to flow back up against gravity. One-way valves (like flapper doors in the drain stack) snap shut after each squeeze to prevent backflow. When those flapper doors break and stay open, water pools on the lower floors (ankle swelling), the pressure crushes the pipes bringing fresh water down (oxygen-starved skin), and rust stains appear on the walls (hemosiderin). Without fixing the broken flapper, you can mop the basement all day (bandage the ulcer) but the water keeps rising because the upstream problem is still broken. Arterial disease is the opposite nightmare—the incoming water pipe (artery) is kinked shut by mineral buildup, so the apartments get almost no fresh water and any small leak in the plumbing becomes a deep, painful hole that will not repair until you unclog the main line.