Chronic venous ulceration is highly arduous complication of venous insufficiency. Although its frequency in the whole population is approximately 0.5-1%, nevertheless, in individuals above the age of 65 it increases up to 5-8%. The socioeconomic analysis has revealed that venous leg ulcer deteriorates social and professional activity of individual patient, but also it becomes significant problem for public health care system, with extremely high expenses for governmental budget. Despite numerous studies focusing on presumable mechanisms of chronic venous ulcer development and healing, the current knowledge in this field is still incomplete. Recently, in addition to “mechanistic” point of view, the role of chronic inflammation and various molecular mechanisms has been extensively studied. In this review authors discuss some promising achievements and perspectives of chronic wound management.