Long-term assessment of chronic leg ulcer treatment by autologous skin grafts.
BACKGROUND
Chronic leg ulcers (CLU) are a common and major cause of morbidity. For this reason, we systematically perform autologous skin grafting.


OBJECTIVE
Long-term evaluation of this treatment.


METHODS
Among the 521 out-patients or those hospitalized for CLU between 1981 and 1993, we assessed 188 (118 women, 70 men, mean age 74 years, 144 grafts, 44 non-grafted).


RESULTS
For the grafted CLU, there were 46 failures (17.5%), 152 (58%) healed in a mean time of 2.2 months and 64 relapsed (24.5%). For the non-grafted CLU, 3 did not heal (3%), 20 relapsed (22.5%) and 66 healed (74.5%) in a mean time of 4.7 months. All the patients who suffered from painful CLU mentioned a regression of pain after the graft. Finally, 87.5% of patients declared that they would accept a new graft.


CONCLUSIONS
We did not note any real difference in closure and recurrence rates between grafted and non-grafted ulcers. This is most likely due to an important selection bias related to the methodology of our study. The grafted ulcers were more serious: they were larger (28.9 against 7.9 cm2) and older (11.1 against 5.6 months).
Ruffieux
P
P
Department of Dermatology, University Hospital, Geneva, Switzerland.
Hommel
L
L
Saurat
J H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001294:Attitude to Health; D001458:Bandages; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006760:Hospitalization; D006801:Humans; D007871:Leg Ulcer / Q000473:pathology / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015983:Selection Bias; D016038:Skin Transplantation / Q000379:methods; D014182:Transplantation, Autologous; D017211:Treatment Failure; D016896:Treatment Outcome; D014945:Wound Healing