Thirty-one operations have been performed on 28 patients for refractory postphlebitic stasis ulcers during the past 15 years. Venous insufficiency had been present 1 to 35 years. The average duration between ulceration and definitive surgery was five years. The ulcers had recurred after ligation and stripping of varicose veins in ten patients and after excision and split-thickness grafting of the ulcer in five patients. Eighteen patients have been followed up for at least five years. The ulcer recurrence rate is approximately 10%.