Split‐Skin Grafting for Ulcers on Legs

Abstract

tute in Copenhagen, 34 patients with ulcers on legs refractory to conservative treatment underwent splitskin grafting during a two-year period. Twenty o f the 34 patients enjoyed complete healing o f their lesions without subsequent recurrences. In five patients the grafts failed completely and in six partially, but in the latter healing proceeded subsequently and satisfactor ily from the edges o f the ulcers. In three o f the 34 patients the ulcers healed spontaneously after slough ing o f the grafts and before re-grafting had to be con sidered. Regardless o f the ultimate results all patients were free o f pain so long as their ulcers were covered with grafts. IN T R O D U C T IO N Patients with recurrent, chronic ulcers on legs pose a great therapeutic problem, partly because o f their large number and partly because the topical treatment is long-lasting and does not always lead to healing.The principles of topical treatment have not altered in essential ways for many years, and as an alternative, grafting has been tried in several clinics. More often, pinch grafts or split-skin grafts of autologous skin have been used.Pinch grafts are small pieces of skin, about 2 x 5 mm in size, that consist of epidermis and the uppermost part of the dermis, taken from donor sites under local anesthesia. Split-skin grafts are largish strips of the epidermis and a thin layer of the dermis that are trans planted generally after removal of necrotic tissue and hypergranulation from the bases of ulcers upon which they are placed. The operation requires general anes thesia.We have used split-skin grafts taken under local an-Dr. Vesterager is on the staff of the

The Technique and Current Status of Pinch Grafting

“…The polyurethane membrane used in the postoperative management of both the donor site and recipient sites is also associated with significant benefits. In addition to minimizing postoperative discomfort at the donor site, 16–18 which in previous experience had always proven to be the most disabling part of the procedure, the polyurethane membrane was able to speed reepithelialization 14 . In the treatment of the ulcer bed, the translucent polyurethane membrane permitted complete and thorough evaluation of the healing wound during the postoperative phase without disturbing the grafts or interfering with healing.…”

“…12). Most impressively, patients will report extremely minimal discomfort at the donor site with this technique 16–18 . Prior to the institution of this modification of the standard pinch grafting technique, the biggest complaint for most patients was that of discomfort at the donor site.…”