BACKGROUND: Less than 10% of venous ulcers are refractory to a conservative treatment with compression bandages. Patients with such chronic or frequently recurring ulcers are candidates for surgical intervention. OBJECTIVE: This review article discusses the various therapeutic modalities for venous ulcers resistant to compression therapy. METHODS: Each therapeutic modality is discussed separately. RESULTS: There are several therapeutic options. It is not easy to determine the proper place of each therapeutic modality in the management of venous leg ulcers. No type of surgical or medical management is truly curative of venous insufficiency, only palliative. An algorithm is proposed, which may serve as a guideline for chosing the best suitable therapeutic option. CONCLUSION: With a better understanding of therapeutic options other than compression therapy the care for each individual patient may be optimized.
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M.J. Korstanje (1995) studied this question.
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