[Treatment of venous leg ulcers]

A venous leg ulcer is a sign of severe chronic venous insufficiency (CVI). Treatment is focused on the cause of CVI and on wound management. The basis of the treatment consists of compression therapy and sufficient exercise (walking). With this, 70% of the ulcers are healed after three months. Surgery is indicated when the venous insufficiency is the result of reflux in the superficial veins. Subfascial endoscopic perforator surgery can be considered in case of insufficient perforator veins but the long-term efficacy has not yet been established. Modern wound management with hydrocolloids, foams or alginates is satisfactory and well tolerated. When the ulcer has healed but the cause of the venous insufficiency cannot be corrected, life-long compression therapy with a flat-knitted therapeutic elastic stocking is necessary to prevent recurrences.