الفهرس 
Introduction and aim of the work
Anatomy of venous valvesOnly 14 pages are availabe for public view
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Abstract
Background: Leg ulcer caused by chronic venous insufficiency (CVI) remain a theraputic dilemma. (CVI) effects roughly 34% of USA population and 10% of these patients ultimately have venous ulceration. (CVU) is one off the major problems commonly encountered in medical practice, a d occur in more than 50% of the vectimes of DVT within 10 years of the orginal attack. ?Objectives: To assess the effectiveness of different modalities of treatment of chronic venous leg ulcer. ?Patients and methods: A total of 40 patients with 40 limbs of chronic venous leg ulcer were randomly assigned to one of two groups as following (groupA) 20 patients with 20 limbs, 16 male 4 female, mean age 40 years, 6 post phlebitic and 14 were primary managed conservatively by leg elevation, ulcer depridement, antibiotics according to culture and sensetivity , venotonic medication, four layer elastic compression bandage with weekly dressing, their hospital stay ranges between 34 weeks.(groupB) 20 patients with 20 limbs, 15 maleS female, mean age 40 years, 1 post phlebitic and 19 were primary managed surgically by Trendlenburge?s operation, stripping of LSV and/or SSV , subfascial perforators ligation, partial skin graft, their hospital stay ranges between 12 weeks. ?Results: After one year follow up (groupA); 19 (95%) patients showed complete ulcer healing and 6 (3 0%) patients showed ulcer recurrence. But in (groupB); 17(85%) showed complete ulcer healing and 3 (15%) patients show ulcer recurrence. Conclusion: This study point out that all patients with CVU must be carefully selected for suitable modality of treatment and show the superiority of surgical treatment over the conservative which still to be applied either in highly selected cases or those cases very resistant to conservative measures, also the study show that multilayer high compression was more effective than single layer.