[Treatment of skin ulcers of venous origin]

Ulceration of the skin is the most severe complication of chronic venous insufficiency of the lower limbs. The ulcer reflects a profound impairment of the venous anatomy and function, often the late sequel to a deep venous thrombosis. The available surgical techniques are rarely apt to repair these lesions completely. Medical treatment is palliative, based upon the strict control of superficial venous hypertension (leg drainage and compression) and the rational use of local therapies (ulcer cleanliness, debridement and dressing). The physician must obtain the co-operation of the patient and the help of a competent nurse. Failures and recurrences are frequent. Rather than to hopeless resignation or even to abandon, such drawbacks should lead to a critical reassessment of each step in the treatment to identify imperfections, and to correct them.