1855DNA in the sera of HBsAg carriers: a marker of active hepatitis B virus replication in the liver. Hepatology 1981 ;l :386-91. were hospital inpatients, 174 (12%) were managed jointly by the primary care team and outpatient departments, and 1201 (83%) were managed entirely in the community.

Six hundred patients with chronic leg ulcers were studied by detailed history and examination as part of a population survey. In 22% ulceration began before the age of40, and in this group the sex incidence was equal. Over age 40 there was an increasing preponderance of women. Ulcers were significantly more common in the left leg in women but not in men. The site of 26% of ulcers did not include the classical medial gaiter area. The median duration of the ulceration at the time of the survey was nine months and 20% had not healed in over two years. The great majority of patients had had recurrence, 66% having had episodes of ulceration for more than five years.Healing of ulcers is a serious problem, but preventing recurrence is the greater challenge. IntroductionChronic leg ulceration affects about 1% of the population at some point in their lives.'4 The results of current management appear to be unsatisfactory, and although a great deal has been published on the merits of a vast range of treatments, few controlled trials have

There was no evidence of a difference in recurrence rates at the classic level of significance (5%), but the lowest recurrence rates were seen in people who wore the highest degree of compression. Therefore, patients should wear the highest level of compression that is comfortable.

Objective To determine whether pentoxifylline 400 mg (Trental 400) taken orally three times daily, in addition to ambulatory compression bandages and dressings, improves the healing rate of pure venous ulcers. Design Randomised, double blind placebo controlled trial, parallel group study of factorial design, permitting the simultaneous evaluation of alternative pharmaceutical, bandaging, and dressings materials. Setting Leg ulcer clinics of a teaching and a district general hospital in southern Scotland. Participants 200 patients with confirmed venous ulcers and in whom other major causal factors were excluded. Interventions Pentoxifylline 400 mg three times daily or placebo. Main outcome measure Complete healing (full epithelialisation) of all ulcers on the trial leg. Results Complete healing occurred in 65 of the 101 (64%) patients receiving pentoxifylline and 52 of the 99 (53%) patients receiving placebo. Conclusions The difference in the healing rates between patients taking pentoxifylline and those taking placebo did not reach statistical significance.

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