title: Healing of venous ulcers of long duration with a bilayered living skin substitute: results from a general surgery and dermatology department.
abstract: BACKGROUND
  A laboratory-grown bilayered living skin substitute (LSS) has been shown to accelerate the healing of venous ulcers. However, issues related to optimal wound bed preparation prior to the application of LSS have not been addressed.
  
  
  OBJECTIVE
  When combined with standard compression therapy and near elimination of wound exudate, bioengineered skin can achieve complete closure of venous ulcers which have been present for more than a year and which are difficult to heal.
  
  
  METHODS
  In the general surgery (center A) and dermatology (center B) departments at two separate medical centers, LSS was used to treat venous ulcers of more than 1 year's duration and which had been unresponsive to conventional therapy. Wound bed preparation at both centers had as common goals the removal of necrotic tissue, optimal formation of granulation tissue, and elimination of wound exudate.
  
  
  RESULTS
  There was great comparability between the two centers in the patients being treated, wound size and duration, and number of LSS applications. Both centers achieved a frequency of complete wound closure of greater than 70% within 6 months.
  
  
  CONCLUSIONS
  At two separate clinical and specialty sites having a common goal of optimal wound preparation, treatment with LSS was associated with a high rate of complete closure of hard to heal venous ulcers.
authors.affiliation: Department of Surgery, Mount Sinai Medical Center, New York, New York, USA.
authors.forename: H
authors.initials: H
authors.lastname: Brem
authors.forename: J
authors.initials: J
authors.lastname: Balledux
authors.forename: T
authors.initials: T
authors.lastname: Sukkarieh
authors.forename: P
authors.initials: P
authors.lastname: Carson
authors.forename: V
authors.initials: V
authors.lastname: Falanga
mesh_terms: D000368:Aged; D001458:Bandages; D003094:Collagen; D003646:Debridement; D006801:Humans; D017768:Skin, Artificial; D013997:Time Factors; D014647:Varicose Ulcer / Q000601:surgery*; D014945:Wound Healing
chemical_list: C117898:Apligraf; D003094:Collagen