Q: My 52 years old sister is suffering from varicose veins with deep wounds just above her ankle. The wounds are very painful and do not heal completely. She is unable to wear stockings because of the wounds. Her weight is 130 kg. Please advise.

A:The varicose veins in this case are a reflection of the overall condition of CVI (chronic venous insufficiency). The formation of the ulcers is the worst complication of the CVI. My advice would be to assess the arterial circulation and if that is satisfactory the ulcers can be treated by a) Ulcer care by dressings and b) Compression with 3 or 4 layer bandage. It is also important that patient should lose weight. Once the ulcer has healed she should have thorough assessment of the CVI and see if any surgery for the varicose veins is needed. The stocking should only be worn once the ulcers have healed.