1: Nutrition Assessment and Management

• We recommend that nutrition assessment be performed in any patient with a venous leg ulcer who has evidence of malnutrition and that nutritional supplementation be provided if malnutrition is identified (Best Practice).

2: Systemic Drug Therapy

• For long-standing or large venous leg ulcer, we recommend treatment with either pentoxifylline or micronized purified flavonoid fraction used in combination with compression therapy (Grade 1, Level B).

3: Physiotherapy

• We suggest supervised active exercise to improve muscle pump function and to reduce pain and edema in patients with venous leg ulcers (Grade 2, Level B).

4: Manual Lymphatic Drainage

• We suggest against adjunctive lymphatic drainage for healing of the chronic venous leg ulcers (Grade 2, Level C).

5: Balneotherapy

• We suggest balneotherapy to improve skin trophic changes and quality of life in patients with advanced venous disease (Grade 2, Level B).

6: Ultraviolet light

• We suggest against use of ultraviolet light for the treatment of venous leg ulcers (Grade 2, Level C).