One of the most common contributors to the development of leg wounds is venous disease. This can occur either because of venous insufficiency—leaky valves in the leg veins or because of issues stemming from a DVT (deep venous thrombosis). Both of these problems contribute by causing high pressure at the ankles that impair the healing of the wounds. Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care physicians in the greater San Francisco Bay Area and Dr. Kokinos is the medical director at both the Verity/O’Connor Wound Care Center in San Jose and St Louise Hospital Wound Care Center in Morgan Hill, CA.

Venous wounds have a classic appearance. The wound is generally around the inner or outer ankle bone and the skin around the wound is often very dark (hyperpigmented). The skin can also be quite leathery. Not everyone with a venous wound has varicose (bulgy) veins, but many do. These can often be painful, and even with excellent care, can take many months to heal. Although the diagnosis can be made by simple examination, it is important to do an ultrasound to get a roadmap of the venous system so that any problems that can be fixed are addressed.

The specialists who deal with the venous system best are called vascular surgeons. These doctors can deal with both leaky valves as well as blockages in the system. It is felt to be very important not only in helping these wounds heal, but in preventing them from coming back, to treat the underlying venous issues. For the leaky valves, this is done by sealing the veins closed, often using the VNUS closure catheter or a laser fiber. For blocked veins, they can often be treated with stents that will hold them open. These procedures are all minimally invasive and can be done in the office setting. With all venous ulcers, compression using medical grade stockings is vitally important. In addition, there is evidence that using an old drug called Trental or a newer one called Vasculera can help heal these wounds faster.


Polyxene Kokinos MD, a Board Certified Vascular and General Surgeon of South Bay Vascular Center and Vein Institute was recently appointed as the new medical director of the O’Connor and St. Louise Hospital’s wound care clinics. Dr. Kokinos brings over 25 years of vascular surgery experience to her new position as medical director and is recognized as a national expert in the treatment of peripheral vascular and arterial disease. Dr. Kokinos has a special interest in the treatment of lower extremity and deep venous disease and is recognized as one of the country’s leading experts in this area. Working in partnership with the award winning Wound Care Center at O’Connor hospital, Dr. Kokinos was selected as the new medical director because of her cutting edge work in peripheral revascularication and ability to bring blood back into the lower leg and foot. Building upon the exceptional wound care services already in place at the O’Connor wound care center Dr. Kokinos will focus on providing state of the art minimally invasive (outpatient) procedures as the next breakthrough in wound care treatment.

Dr. Kokinos and her Partner Dr. Carlos Pineda, both board certified vascular surgeons are recognized as two of the leading wound care doctors in San Jose, Silicon Valley and all of Northern California. While podiatrists have always been the traditional starting point for the evaluation of and treatment of non-healing leg wounds, it is only the Vascular Surgeon who is fellowship trained to be able to evaluate and to treat the underlying cause of most non-healing wounds: poor circulation. Unfortunately, in many instances skin supplements, hyperbaric chambers and wound debridement are not enough to correct the underlying circulatory issues responsible for non-healing leg, foot and ankle wounds.

Dr. Kokinos is honored to be selected as the medical director at the O’Connor and St Louis Wound Care clinic’s and is excited to bring patients the most recent advances in wound care treatment to help keep Silicon Valley’s best wound care clinics at the forefront of patient care.