title: Skin grafting for the treatment of chronic leg ulcers - a systematic review in evidence-based medicine.
abstract: Skin grafting is one of the most common surgical procedures in the area of non-healing wounds by which skin or a skin substitute is placed over a wound to replace and regenerate the damaged skin. Chronic leg ulcers are an important problem and a major source of expense for Western countries and for which many different forms of treatment have been used. Skin grafting is a method of treatment that decreases the area of chronic leg ulcers or heals them completely, thus improving a patient's quality of life. Skin grafting is an old technique, rediscovered during the first and second world wars as the main treatment for wound closure. Nowadays, skin grafting has a pivotal role in the context of modern wound healing and tissue regeneration. The aim of this review was to track and to analyse the specific outcomes this technique achieved, especially in the last decade, in relation to venous, arterial, diabetic, rheumatoid and traumatic leg ulcers. Our main findings indicate that autologous split-thickness skin grafting still remains the gold standard in terms of safety and efficacy for chronic leg ulcers; skin grafting procedures have greater success rates in chronic venous leg ulcers compared to other types of chronic leg ulcers; skin tissue engineering, also supported by genetic manipulation, is quickly expanding and, in the near future, may provide even better outcomes in the area of treatments for long-lasting chronic wounds.
authors.affiliation: Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Rizzuto
authors.affiliation: Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Perri
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barbetta
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Karim
authors.initials: K
authors.lastname: Abdalla
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Santo
authors.initials: S
authors.lastname: Caroleo
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hospital of Saint-Flour, Saint-Flour, France.
authors.forename: Chiara
authors.initials: C
authors.lastname: Longo
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amantea
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sammarco
authors.affiliation: Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, Italy.|Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D014647:Varicose Ulcer / Q000175:diagnosis* / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology*
keywords: Arterial ulcer; Chronic leg ulcer; Diabetic ulcer; Skin graft; Venous ulcer