Diagnosis
10
Induration:
Presumes
venous origin of
secondary skin
and subcutaneous
changes (i.e.,
chronic edema
with fibrosis,
hypodermitis).
Includes white
atrophy and
lipodermatoselerosis
Limited to
perimalleolar
area
Diffuse over
lower third
of calf
Wider
distribution
above lower
third of calf
Active ulcer number
0 1 2 ≥3
Active ulcer
duration (longest
active)
N/A <3 mo >3 mo but
<1 y
Not healed
for >1 y
Active ulcer size
(largest active)
N/A Diameter
<2 cm
Diameter
2–6 cm
Diameter
>6 cm
Use of compression
therapy
0
Not used
1
Intermittent
use of
stockings
1
Intermittent
use of
stockings
3
Full
compliance:
stockings
Modified from Vasquez MA, Rabe E, McLafferty RB, Shortell CK, Marston WA,
Gillespie D, et al. Revision of the venous clinical severity score: Venous outcomes
consensus statement: Special communication of the American Venous Forum Ad Hoc
Outcomes Working Group. J Vasc Surg. 2010;52:1387-1396.
Table 5. Revised Venous Clinical Severity Scoring (VCSS)
System (cont'd)
None: 0 Mild: 1 Moderate: 2 Severe: 3
