Antimicrobial treatment, based on the theoretical basis that lower limb venous ulcer will basically be combined with infection, first of all, antimicrobial treatment is needed for patients, and local infection foci can be taken to perform bacterial culture to confirm comfortable combined with special bacterial infection, according to the long-term treatment experience of Professor Zhao Yu of the First Hospital of Chongqing Medical University, antimicrobial drugs can be used topical mupirocin ointment which is sensitive to Gram-positive bacteria, and penicillin is given at the same time. The above two drugs are good for local infection control, do not perform invasive operations under poor infection control, the chances of trauma infection will be greatly increased after the operation. In addition, the thromboxane injection used in the treatment can activate blood stasis and dilate blood vessels; the mucopolysaccharide polysulfate cream applied externally has the function of anticoagulation and antiplatelet; the sodium heptaerythrone saponin gel acts on the blood vessel wall to reduce its permeability, reduce the extravasation of fibrin and other substances, and also promote the reabsorption of edema. The above three drugs act on the affected limb to improve local microcirculation, increase the supply of nutrients and oxygen, promote metabolism, enhance local resistance to infection, and promote ulcer crusting and healing. Surgical treatment: The purpose of surgery is to eliminate the cause of the disease and reduce the pressure of venous reflux, in the past, it was emphasized that the treatment of deep venous blood reflux status was preferred, but now it is believed that not all affected limbs with incomplete deep venous tributaries must choose deep venous opening or valve reconstruction, otherwise it may make some patients who can improve deep venous function by simple superficial venous surgery unnecessarily undergo more complicated and traumatic surgery. For patients with combined deep vein insufficiency, superficial vein surgery can be performed first, and then deep vein repair can be considered when the initial superficial vein surgery is not effective if the clinical classification is mild or moderate, and only patients with severe chronic venous insufficiency of the lower extremity should consider superficial vein surgery combined with deep vein opening or valve reconstruction. Therefore, for the majority of patients with venous ulcers of the lower extremities, elimination of the cause of superficial varicose veins is still the main treatment modality. Management of the saphenous vein: Because most patients with venous ulcers of the lower extremities have C4 to C6 lesions in the CEAP classification, traditional high ligation (including dissection of at least 2 branches, the medial and lateral superficial femoral veins) and management of the saphenous vein trunk should be performed. Trunk management includes conventional stripping, transilluminated venous shaving aspiration, endovenous laser therapy, radiofrequency ablation, and endovenous microwave therapy. A variety of procedures are available and can be chosen according to the specific conditions of the local hospital. Ulcer localization and traffic branch treatment: At present, there are many methods for ulcer localization and traffic branch treatment in China, and one or more of the following methods can be used: sclerotherapy, laser therapy, TriVex surgery, suture ligation, Linton surgery and lumpectomy for deep subfascial traffic branch ligation. Regardless of the method, the aim is the management of the diseased traffic branch and the removal of subcutaneous necrotic tissue from the ulcerated skin. The management of the penetrating branch is more important and the procedure is difficult. Intraoperatively, the penetrating branch is treated with laser or sclerotherapy under the localization of ultrasound. In the absence of instruments, a small incision can be made in the healthy skin surrounding the ulcer and a large vascular clamp can be placed to peel the ulcer and its surrounding subcutaneous tissue. The TriVex rotary incision procedure is particularly advantageous in the treatment of venous ulcers of the lower extremities. In the lesioned skin area, pigmentation and crust scarring often make it difficult to see all the varicose veins under direct fluoroscopy, so extensive scalloping of the subcutaneous tissue in the lesioned area can thoroughly treat the superficial varicose veins and effectively prevent recurrence of the ulcer; in addition, the infected tissue and fibrous scar layer can be removed more thoroughly, physically reducing the total amount of bacteria contained in the subcutaneous tissue in the lesioned area. In combination with the application of postoperative antibiotics, the healing time of the ulcer can be shortened. At the same time, the removal of the fibrous scar layer reduces the physical barrier between oxygen and nutrients and the lesioned skin, and the postoperative compression bandage can also closely adhere the skin to the subcutaneous tissue, which facilitates the growth of new blood vessels and the supply and exchange of oxygen and nutrients, and promotes the metabolism of the lesioned area, thus accelerating the healing of the ulcer. For superficial vein treatment: one or a combination of the following methods can be used: surgical or spot stripping, sclerotherapy, laser therapy, TriVex surgery, suture ligation, etc. For departments without instrumentation, spot stripping is also a near cosmetic method, and combining sclerotherapy and stripping will give better results. The new sclerosing agent, polydocanol (Anshouxi), has indications for varicose vein treatment in the lower extremities and is suitable for lesions at all levels from C1 to C6. There are three different concentrations available in China, of which 0.5% of the original solution is specifically used for capillary dilation and sclerotherapy of reticular veins, 3% of the original solution is made into foam with air at 1:4 and used for the treatment of trunk or overly thick varicose veins, and 1% of the concentration is 1:3 or 1:4 foam is used for the sclerosis of varicose veins. For varicose veins <4-5 mm in diameter, foam sclerotherapy has significant advantages in terms of efficacy and postoperative recovery. For significantly thickened varicose masses, units with TriVex equipment can administer sclerosing agent followed by TriVex planing, which significantly reduces bleeding and facilitates planing of the sclerotic varicose vein. Some people doubt the minimally invasive nature of the TriVex planing technique, but it is possible to achieve minimally invasive treatment after mastering the technical points and techniques, one is to first sclerosis the thick vein mass before planing; second is to plan along the vein and not to do too much subcutaneous separation except for the local ulcerated lesion area; third is to adopt the principle of high negative pressure and low speed; fourth is to emphasize the adequate flushing of the swelling solution, and the swelling solution should be added with antimicrobial agent; fifth is not to emphasize the complete flushing of the varicose veins with The varicose veins with skin adhesions are completely removed and their continuity can be destroyed, so even partial removal can achieve the treatment purpose. Postoperative treatment: The postoperative treatment focuses on the treatment of chronic infection and ulcer wound care. Postoperative elastic bandages are applied to the operated limb, and blood activation and swelling treatment are given. The application of low molecular heparin and rivaroxaban and early bed activity after surgery can effectively prevent the occurrence of deep vein thrombosis in the lower limbs. Observe the dorsalis pedis artery pulsation, skin temperature and sensation of the affected limb to determine the blood circulation and patency of the affected limb. Elevate the affected limb and encourage early dismounting to promote the blood circulation of the affected limb. It is found that benzathine penicillin plays an important role in the follow-up treatment of venous skin lesions of the lower limbs. Due to anatomical factors, the lower limbs, especially the anterior tibial skin, are located at the end of the systemic blood supply, and it is difficult to maintain the effective blood concentration of common antibiotics locally, while benzathine penicillin, as a long-acting slow-release preparation, can release penicillin components into the lesion slowly after a deep intramuscular injection, and maintain the effective blood concentration for a long time. It can maintain the effective blood concentration for a long time to exert continuous antibacterial effect. It can maintain the antimicrobial effect for a long time after a single dose, and the dosing interval and the total course of treatment can be flexibly adjusted according to the improvement of skin lesions during the outpatient follow-up.