A large proportion of the population, particularly the elderly, suffer from venous insufficiency which regularly leads to the development of leg ulcers. Delayed wound healing is a major problem in ulcers making them a target for both conventional and newly developed advanced therapies. Good compression therapy and wound cleansing are essential for wound healing. A number of advanced local application therapies are currently being developed that are aimed particularly at the 'hard-to-heal' group. These therapies include the application of tissue-engineered skin substitutes.