<b><br>Introduction:</b> Severe forms of chronic venous insufficiency (CVI) CEAP C3-C6 occur in 17-20% of all CVI cases among adults.</br> <b><br>Aim:</b> The aim of this study was to compare the standard treatment of CVI C6 with endovenous methods and cellular technologies.</br> <b><br>Materials and methods:</b> Group I consisted of 28 patients with trophic ulceration treated using modern wound coverings, cell technologies and minimally invasive operations. Group II had 42 patients with trophic ulceration who underwent crossectomy with stripping of the trunk of the target vein and local treatment with "standard" ointments. The results of the treatments were evaluated using the Venous Clinical Severity Score (VCSS), the Numeric Pain Rating Scale (NPRS), and ulcer healing time.</br> <b><br>Results:</b> After 1 month, the VCSS scores were 13.8 2.3 and 16.4 3.3 points in Groups I and II, respectively; after 3 months, they were 10.2 2.1 and 13.6 2.4 points. VLU was healed in 20 (71.43%) and 16 patients (38%) after 3 months in Groups I and II, respectively; in 26 (92.86%) and 30 patients (71.43%) after 6 months; and in 28 (100%) and 40 patients (95.24%) after 12 months. After 1, 3, and 6 months, occlusion of the target segment was achieved in 14 patients (100%) of Group I. NPRS was significantly lower in Group I. The hospital stay in Group I was 8.2 2.4 days, while for Group II it was 14.5 3.8 days.</br> <b><br>Conclusions:</b> The use of modern wound coverings, platelet-rich plasma (PRP), and negative-pressure wound therapy (NPWT) reduced the period of preoperative preparation and sped up the stage of cleaning and healing of VLU compared to conventional wound coverings in patients with CVI C6.</br>.