Venous ulcer is an extremely common aetiology of lower extremity ulceration, which affects approximately 1% population in most of the countries, and the incidence rate increases with age and female gender. Proper assessment and diagnosis of both the patient and ulcer are inevitable in order to differentiate venous ulcers from other lower extremity ulceration and to frame an adequate and individualised management plan. Venous ulcers generally persist for weeks to many years and are typically recurrent in nature. This consensus aims to present an evidence-based management approach for the patients with venous ulcers. Various management options for venous ulcers include compression therapy, minimally invasive procedures like sclerotherapy and ablation techniques, surgical procedures, debridement and medical management with micronised purified flavonoid fraction (MPFF). Compression therapy is the mainstay treatment for venous ulcer. However, in failure cases, surgery can be preferred. Medical management with MPFF as an adjuvant therapy to standard treatment has been reported to be effective and safe in patients with venous ulcer. In addition to standard therapy, diet and lifestyle modification including progressive resistance exercise, patient education, leg elevation, weight reduction, maintaining a healthy cardiac status and strong psychosocial support reduces the risk of recurrence and improves the quality of life in patients with venous ulcer.

What does the term "chronic venous disease" cover? The term "chronic venous disease" (CVD) covers a full spectrum of venous conditions of lower limbs, ranging from patients with early symptoms, like telangiectasia (reticular veins), leg pain, or oedema of the foot, to complications like venous leg ulcers. In the early stages usually only symptoms appear, then as the disease progresses it is accompanied by signs. Venous symptoms are defined as tingling, aching, burning sensation, muscle cramps, swelling, sensations of throbbing or heaviness, itching skin, restless legs, leg tiredness, or fatigue. These may be exacerbated during the course of the day by prolonged standing or by heat, and relieved with leg rest, elevation, or both. Venous signs are visible manifestations of chronic venous disease, which include [1]: • Oedema of the dorsum of foot, the entire foot, possibly extending to the leg; • Frank varicose veins: this may or may not be associated with telangiectasia or reticular veins; • Skin changes: dryness, frank eczema, darkened, thickened, hard, scarred, and ulcers.

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