2013 cochrane systematic review aimed to determine the effectiveness of foam dressings for helping to heal venous leg ulcers. the authors concluded that is uncertain whether or not foam dressings are more effective than other dressing types and that more randomized controlled trials are needed to help answer this research question. however, there is some evidence that ibuprofen dressings may offer pain relief to people with venous leg ulcers. prognosis venous ulcers are costly to treat, and there is a significant chance that they will recur after healing; one study found that up to 48% of venous ulcers had recurred by the fifth year after healing. however treatment with local anaesthetic endovenous techniques suggests a reduction of this high recurrence rate is possible. without proper care, the ulcer may get infected leading to cellulitis or gangrene and eventually may need amputation of the part of limb in future. some topical drugs used to treat venous ulcer may cause venous eczema. research the current 'best' practice in the uk is to treat the underlying venous reflux once an ulcer has healed. it is questionable as to whether endovenous treatment should be offered before ulcer healing, as current evidence would not support this approach as standard care. the evra (early venous reflux ablation) ulcer trial, a randomised clinical trial funded by the national institute for health and care research (nihr) to compare early versus delayed endovenous treatment of superficial venous reflux in patients with chronic venous ulceration, opened for recruitment in october 2013. the study hopes to show an increase in healing rates from 60% to 75% at 24 weeks. research from the university of surrey and funded by the leg ulcer charity looked at the psychological impact of having a leg ulcer, on the relatives and friends of the affected person, and the influence of treatment.