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Arteriovenous shunting could have accounted for these findings, but no evidence of shunting in patients with venous insufficiency was found.

The complete lack of evidence to support a hypoxia/stasis theory has led many investigators to advocate the abandonment of the term stasis dermatitis.

Disturbed function of the 1-way valvular system in the deep venous plexus of the legs results in a backflow of blood from the deep venous system to the superficial venous system, with accompanying venous hypertension.This rise in pressure leads to increased permeability of dermal capillaries.This increased permeability enables macromolecules, such as fibrinogen, to leak out into the pericapillary tissue; then, polymerization of fibrinogen to fibrin results in the formation of a fibrin cuff around dermal capillaries.Fibrin cuffs are not found in ulcers due to causes other than venous hypertension.Decreased cutaneous fibrinolytic activity has been proposed to contribute to the formation of fibrin cuffs.

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Injuries to the venous system due to trauma or surgery are common factors in the development of stasis dermatitis.

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