Severity Score

Attribute Absent = 0 Mild = 1 Moderate = 2 Severe = 3
Pain None Occasional, not restricting activity or needing analgesics Daily, moderate activity limitation, occasional analgesics Daily severe, limiting activity or needing regular use of analgesics
Varicose veins None Few scattered or branch VVs Multiple: LSV varicosed & confined to calf or thigh Extensive in thigh and calf involving thigh and calf
Venous oedema None Evening ankle oedema only Afternoon oedema above ankle Morning oedema above ankle needing elevation & activity change
Skin pigmentation None or focal, low intensity (tan) Diffuse but limited in area & old (brown) Diffuse over lower 1/3 leg or recent pigmentation Distribution above lower 1/3 and recent pigmentation
Inflammation None Mild cellulitis around ulcer area Moderate cellulitis involving lower 1/3 Severe cellulitis lower 1/3 and above or significant venous eczema
Induration None Focal circum malleolar (<5 cm) Medial or lateral < lower 1/3 leg Entire lower 1/3 leg or more
No. Of active ulcers 0 1 2 >2
Active ulceration duration None <3 months >3 months,<1 yr Not healed >1 yr
Active ulcer size None <2 cm diameter 2-6 cm diameter >6 cm diameter
Compressive therapy Not used or not compliant Intermittent use of stocking Wears elastic stocking most days Full compliance: stocking + elevation

Grading of Varicose and their treatment recommended according to the grade