Reversing the high pressure within the veins and local ulcer management are the two mainstays of successfully treating venous chronic leg ulceration: 1) A number of treatment strategies may be incorporated into your care plan to reverse the high pressure within the leg veins. These include: Leg elevation, such that your heel is higher than your hip with the leg straightened reduces the pressure within the leg veins through the effects of gravity. Thus, when sitting down patients are encouraged to elevate their legs on a stool; similarly, at night elevating the foot of the bed will aid in ulcer healing. Compression bandaging or compression stockings reduce the pressure within the leg veins when standing. The majority of patients will require compression bandaging initially with several layers of bandages applied in order to achieve pressure control. These will need to be changed regularly (sometimes daily) due to weeping of the underlying ulcers; as pressure control is achieved the degree of ulcer weeping diminishes and thus the frequency of bandaging change reduces. Once the ulcer is healed a custom fitted compression stocking is applied to prevent recurrence. Surgery may be recommended where an underlying vein anomaly is identified and amenable to surgical correction. In the majority of cases we prefer to attain ulcer healing with ‘compression and elevation’ before offering definitive treatment for underlying venous insufficiency. However, in some cases concomitant treatment of the underlying cause may expedite the healing of stubborn venous ulceration (See Varicose veins and May-Thurner syndrome). 2) Local Ulcer Management Infection control is paramount to attain ulcer healing. This may be achieved through a combination of systemic antibiotics, local antimicrobial dressings and regular washing of the ulcer with an antiseptic solution such as potassium permanganate. Ulcer dressings are an important aspect of ulcer care with a plethora of dressing available on the market. There is very little clinical evidence to support one dressing type over another. We firmly believe in evidenced based medicine and in our experience a simple atraumatic, absorbent dressing is often sufficient to control the ulcer whilst the underlying cause is addressed. Skin grafting, on rare occasions, may be used to facilitate healing of ulcers that have failed to heal despite adequate treatment of the underlying cause.