"ound in a moist environment. Modern dressings are occlusive or semi-occlusive, classified according to their physical composition. Published systematic reviews of the value of different types of dressings in the management of chronic wounds provide only weak levels of evidence of their clinical efficacy, in terms of healing rate. Nevertheless, the indications for modern dressings were recently determined according to a systematic review of the literature and to a formal consensus process. Despite the lack of appropriate studies, modern dressings remain a part of the standard of care and are wi"

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"olves layered tangential and only suprafascial necrosectomy and fibrosectomy of nonhealing venous leg ulcers, combined with simultaneous skin grafting. In spite of very good long-term results confirmed by several investigators and published as a retrospective analysis, there are no prospective and randomized studies. Long-term healing rates between 70% and 80% for recalcitrant venous leg ulcers are very good, and no other current method is able to achieve comparable results. Further advantages are a simple technique, short intervention, and safety, with few complications. On account of the low"

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"o conservative therapies, and the presence of non-healing or recurrent ulcers may lead one to consider surgery. However, even if surgery is properly indicated, traditional techniques such as femoral transposition and valve transplantation are not always suitable, and in these cases a de novo valve reconstruction represents a surgical opportunity. Our neovalve reconstruction technique consists in creating an intimal flap by performing a wall dissection. The purpose is to create an antireflux mechanism that reduces venous hypertension. This technique was applied from December 2000 in 39 selected"

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