الفهرس 
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Abstract
BACKGROUND
Many methods of treatment have been described for venous ulcer in a trial to deal with the problem and its two pathological aspects i.e. venous hypertension and chronic tissue damage. These methods can be categorized into two main categories which are ; conservative methods and surgical methods The surgical treatment concern with both aspects , tissue damage through excision of ulcer with consequent graft or flap coverage and venous hypertension through subfacial ligation of the perforators either endoscopic or open surgery , or through vein valve surgery
Patients & Methods
This observational prospective study included 20 patients randomly selected regarding age and sex they presented with chronic venous ulcer due to venous insufficiency and had their ulcers of at least 6 weeks duration according to Crane et al 2004.
The operations
A) Superficial vein surgery (Trendlenburg’s Operation& Long saphenous vein stripping)
B) Perforator interruption:(Endoscopic technique SEPS).
C) Ulcer excision followed by covering the defect with split thickness graft.
Results
10 patient male and 10patient female .ages 31-51 .14patient vv 6 pp .all the ulcer in the gaiter area 14 small ulcer <5cm^ 6 large ulcer>5cm^. Healing of 18 cases after 6mothes no healing 2cases and partial loss of the graft 4cases.
This study demonstrated the effectiveness of the SEPS & STG &SVS procedure when incorporated into the overall treatment strategy for patients with chronic venous insufficiency. Minimal postoperative complications accompanied by ulcer healing and relief of lower extremity symptoms were achieved for 90% of patients.
Key word
Subfacil ligation. Split thickness graft. Chronic venous ulcer.