A venous refill time without tourniquet is found to be 10 seconds and with the tourniquet is found to be 30 seconds. What does this indicate?

The scenario described indicates that there is a notable difference in venous refill time both with and without a tourniquet. When the venous refill time is shorter without the tourniquet (10 seconds) and longer with the tourniquet (30 seconds), it suggests that the superficial venous system is incompetent.

In a healthy venous system, the application of a tourniquet usually results in a slower refill time because the superficial veins are prevented from draining properly, thereby causing blood to pool. If the refill time is significantly longer with a tourniquet, it demonstrates that the superficial veins are unable to maintain normal function.

On the other hand, the rapid refill time without a tourniquet indicates that the deep venous system is likely functioning adequately, as it allows for efficient drainage of blood from the superficial system. Hence, the findings suggest superficial incompetence, signifying a problem with the superficial venous structures, while the deep system remains intact and competent. This interpretation aligns with the clinical understanding of venous assessment and highlights the functionality of different venous systems under varying conditions.