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. PATIENTS AND 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).