Surgical management of venous stasis disease: an update.

The management of leg ulcers of venous origin begins with patient cooperation. Bed rest, leg elevation, and local care should relieve pain and initiate healing. This can be facilitated or managed on an outpatient basis by using an Unna's boot. Superficial varicosities should be ligated and stripped, and perforators identified by venography should be ligated and divided subfascially. Ulcers can then be excised and grafted. Long-term care includes chronic use of compression hose.