Venous leg ulcers (VLUs) are the most severe manifestation of chronic venous disease (CVD), which, due to their chronic nature, high recurrence rate and slow healing time, account for 80% of all leg ulcers.

VLUs impose a heavy burden on patients that reduces their quality of life and represents a major socioeconomic impact due to the cost and duration of care.

The primary medical approach to treating VLUs is using local compression therapy in combination with venoactive drug (VAD) pharmacotherapy to promote the reduction of the inflammatory reaction initiated by the venous hypertension.

Micronized purified flavonoid fraction (MPFF; Daflon®) is the most widely prescribed VAD, which counteracts the pathophysiologic mechanisms of CVD and ulceration and has proven to be an effective adjunct to compression therapy in patients with large and chronic VLUs.

Two other drugs, pentoxifylline and sulodexide, both of which are not VADs, have also been shown to improve VLU healing and are recommended in addition to compression therapy. However, MPFF has been the only VAD with the highest recommendations in the 2018 guidelines for the healing of VLUs.